Owner Surrender Form

Taylor County SPCA

Animal Surrender Form
I UNDERSTAND THAT BY COMPLETION AND SIGNING OF THIS FORM I RELINQUISH ALL RIGHTS AND OWNERSHIP OF THE ANIMAL DETAILED BELOW TO THE TAYLOR CO SPCA.

I CONFIRM THAT BY SIGNING THIS I AM HAPPY TO DO SO AND TO ALLOW THE TAYLOR CO SPCA TO FIND A SUITABLE HOME FOR THE ANIMAL UPON COMPLETION OF THEIR OWN ASSESSMENTS.
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City/Town County

Post Code
Email
example@example.com
Phone Number

Area Code Phone Number
Animals Name
Type of animal (i.e dog/cat/rabbit etc)
Breed of Animal
How long have you had this animal
Age of Animal
Where did you originally get the animal
Is the animal spayed/neutered?
Is the animal up to date with all vaccinations?
What veterinarian has the animal received vet care at?
What areas of your home did the animal have access to? (check all that apply)

Indoor Only Outdoor Only Indoor/Outdoor
How active is the animal

Very Active Somewhat Active Lazy
I would describe the animal as

Family oriented Adults Only Only Pet A one person animal
This animal lives with

cats dogs children
How does the animal handle men
How does the animal handle women
How does the animal handle children
How does the animal handle strangers
How does the animal handle cats
How does the animal handle dogs
Has this animal ever bitten aggressively?
Is the animal house broke (if dog) / litter box trained (if cat)
Frequency of accidents indoors

Never Occasionally All the time Outdoor animal
My animal has the following health concerns
My animal is on the following medication(s)
Please explain why you are looking to surrender your pet.
ANY ADDITIONAL COMMENTS OR HELPFUL INFORMATION:
Are you the legal owner of the animal?
If you answered no the previous question, please state your relationship to the legal owner
Signature
Date

Month Day Year
Date
Should be Empty:

Taylor County SPCA