Name * First Name Last Name Email * Phone * (###) ### #### In what county do you reside? * Breed of dog * Age of dog * Sex of dog * Female Male Estimated weight of dog * Is dog spayed/neutered? * Yes, dog is spayed/neutered ("fixed") No, dog is NOT spayed/neutered ("fixed") How long have you had the dog? * Where did you get the dog? * Why are you trying to surrender your dog? * Does the dog get along with other dogs? * Yes, dog gets along with other dogs No, dog does NOT get along with other dogs Dog has never been around other dogs Does the dog get along with cats? * Yes, dog gets along with cats No, dog does NOT get along with cats Dog has never been around cats Do you have health concerns about the dog? If so, what are they? * Do you have behavioral concerns about the dog? If so, what are they? * How soon do you need to release it? * Is it up to date on vaccinations (shots)? * Yes, up to date on shots No, not up to date on shots Received some vaccinations Is animal housetrained? * Yes, fully housetrained No, not housetrained at all Outside only, don't know if housetrained Pee-pad trained Housetrained with accidents Is animal good around kids? * Yes No Never been around children Thank you for the information about the animal you want to surrender. One of our volunteers will respond to you within a few days, usually via email.
