Surrender

Dog Surrender Application Form

Please answer all the questions to the best of your knowledge. You will need to attach 2 photos of your dog at the end of this form to complete this application.
Tell us your name*
Tell us your mobile number*
Tell us your full address (inc postcode)*
Tell us your email address*
Tell us your dogs name*
Tell us your dogs age/date of birth*
Tell us the breed of your dog*
Tell us where you acquired your dog from *
Breeder, rescue (which one), friend, etc.
Is your dog*

MaleFemale
Is your dog neutered*

YesNo
Please tell us the microchip number of your dog*
Are your dogs vaccinations up to date? If you answer yes you will need to provide proof of the vaccination expiry date.*

YesNo
On what date does the vaccinations expire.

DayMonthYear
Date
Getting your dogs vaccinations up to date costs the charity at least £40. Are you in a position to help cover the cost of this should your dog be admitted into the rescue centre.

YesNo
Tell us about your dogs medical condition and history.*
How does your dog react when it sees other dogs outside the home?*
Does your dog share a home with children?

YesNo
Does your dog suffer from anxiety? If so tell us the reaction and what causes it.*
Tell us about any fears your dog has.*
Has your dog ever bitten or gone to bite another animal? If so please give details.*
Has your dog ever bitten or gone to bite a person? If so please give details.*
Does your dog show aggression/dominance to people/animals? If so please give details.*
How does your dog react to strangers?*
Is your dog house trained?*

YesNo
Does your dog settle well when left in the home alone?*

YesNo
Tell us why you need to surrender your dog into rescue.*
You now need to upload recent photos of your dog. We will require at least 2 photos.

Please follow the guidelines below for sending photos.

The first photo needs to be a clear shot of your dog standing face on towards the camera but not taken from above.

The second photo needs to be a side shot of your dog, again not taken from above.
Following the photo guide above please upload photos of your dog here.

Upload Files Here

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Use this space if you have any other information you want us to know about
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Dog Surrender Application Form