PET RELINQUISHMENT AGREEMENT

PET RELINQUISHMENT AGREEMENT
I certify I am the owner/owner's agent of the pet described below. As the owner/owner's agent, I now hereby relinquish ownership of this pet to New Baltimore Animal Hospital for rescue, placement, or euthanasia.

I understand New Baltimore Animal Hospital will do what they feel is in the best interest of this pet, without repercussion from me.

With my signature below, this pet becomes the property of New Baltimore Animal Hospital.
Species*
Breed*
Sex/Gender*

MaleNeutered MaleFemaleSpayed Female
Age*
Color*
Pet's Name*
Owner/Owner's Agent Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature*

Clear
Date*

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Date
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