Name * First Name Last Name Email * Phone * (###) ### #### Breed of dog * Age 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? * Why are you trying to surrender your dog? * 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 Does it have have any health or behavioral concerns? * Yes No, no health/behavioral concerns 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.
