Small Animal/Bird Surrender Form
Rabbits, Guinea Pigs, etc.
Street Address Line 2
State / Province
Postal / Zip Code
Please enter a valid phone number.
Age of Pet:
Is your pet:
Where did you aquire your pet?
Other Shelter/ Rescue
Why are you surrendering your pet?
What types of food do you feed your pet?
Brand of food:
Where does your pet spend most of it's time?
Free Roam (Inside home)
Single Enclosure (Inside home)
What type & size is your pet's cage?
Is your pet litter box trained?
Has your pet bitten or scratched anyone? If yes please explain
What other pets live in your house?
No other animals
Other small animal(s)
Pet's reaction to being picked up?
Has your pet had any health problems in the past?
Has your pet been seen by a veterinarian?
If yes, please provide the Veterinarian's name and phone #
Upload an Image of your pet here:
Drag and drop files here
Choose a file
Is there anything else that you would like us to know about your pet?
Should be Empty: