Intake Request

K9 Rouge Rescue
Canine intake request

If you need to surrender a canine whether it is your dog or a stray, please fill out the below information for review. Since all of our canines are cared for inside foster homes until they are adopted, we cannot accept any type of aggressive dogs. Please complete and submit this form. Someone from K9 Rouge Rescue will contact you after reviewing the completed form.

There is a $50 fee due at the time the canine is accepted.

Full Name*

First NameLast Name

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Cellular*

Area CodePhone Number

Please list the canines you would like to surrender into the care of the K9 Rouge Rescue. Please include their name, sex, age, weight, description, and personality. If the animal is a stray please make that notation and do the best you can to answer the questions below. You can list everything in one box if it is a litter of puppies.

Canine #1*

Canine #2

Canine #3

Canine #4

Canine #5

Is your canine(s) a primarily inside or outside dog?*

Is your canine(s) currently up to date with their vet including vaccinations and annual care? *

Currently on heartworm and flea prevention?*

Any medical conditions we should be aware of?*

Spayed or Neutered?*

YesNoNot sure

Reason for surrendering? Please make a notation if this dog was found and is currently a stray.*

Please attached photos here or email them to K9rougerescue@gmail.com

Browse Files

How will you surrender the canine into our care?*

I will meet you somewhere in Baton Rouge.I am unable to meet. I will need someone to pickup this animal in Baton Rouge.I live outside of Baton Rouge and cannot travel to Baton Rouge to surrender this animal.

If you cannot travel to Baton Rouge and don't live in Baton Rouge, where can our rescue meet you?*

By sending this electronically, I acknowledge that I have completely read this form and comprehend it fully. I certify that the above information is correct.

I also understand that if I am not the owner/keeper/caretaker/custodian of the animal/s listed above, I will not be able to relinquish the custody if my form is approved. Stray surrenders will be handled separately.

Date*

MonthDayYear

Electronic Signature*