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Dog Owner Surrender 

Dog Owner Surrender Questionnaire

Sex of Dog
Male
Female
Spayed or Neutered
Yes
No
Unknown
Is your dog microchipped?
Yes
No
Unknown
Why are you surrendering your pet?
Where did you get your pet?
Current on Vaccines?
Yes
No
Unknown
Does this pet have any medical conditions or previous injuries?
Yes
No
Has this pet ever bitten a person or other animal?
Yes
No
Where did your dog spend most of it's time?
Is your dog housebroken?
Yes
No
Is your dog crate trained?
Yes
No
What type of food does this pet eat?
Dry
Canned
Special Diet (please specify in the ADDITIONAL NOTES section below)
Has your dog ever been around other dogs?
Yes
No
Does your dog play well with other dogs?
Yes
No
Unknown
Has your dog ever lived in a home with cats?
Yes
No
Is your dog fearful of
Does this pet have any behavior issues or destructive tendencies?
Yes
No
Have you tried to re-home your pet?
Yes
No
Do you understand that if you surrender this animal to us that it is a possibility that we will have to euthanize this animal (put it to sleep)?
Yes
No
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