Pet Surrender Pet Surrender Form Name* First Last Email* Phone*What is your situation? Why are you looking to surrender your dog or cat?*Dog -- what breed?House trained?*YesNoDon't KnowCat Litter Trained DeclawedIs pet spayed/neutered?*YesNoDon't knowIs pet up-to-date on vaccinations?*YesNoDon't knowIs pet on flea and heartworm preventative?*YesNoDon't knowVeterinarian Name* First Last Veterinarian Phone*Is pet in good health?*If not in good health, please explain.Does pet get along with dogs?*YesNoDon't knowDoes pet get along with cats?*YesNoDon't knowDoes pet get along with children?*YesNoDon't knowDoes pet get along with women?*YesNoDon't knowDoes pet get along with men?*YesNoDon't knowDoes pet react well to strangers?*YesNoDon't knowHas this pet ever bitten or nipped anyone?*YesNoDon't knowCurrent photo of pet if availableAny comments or other information you can share with us about this pet?Signature*By signing this form, I hereby surrender all rights to the animal. To my knowledge, no other person has any right to this animal. I understand that once I relinquish the animal, it will not be available to be returned.