Return Request

Return Request

Contact Information
Which shelter did you adopt this pet from?*

Redwood CityPalo Alto
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Secondary Number
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your name the primary adopter on the adoption paperwork?

YesNo
Name of person who signed adoption paperwork:
The following questions will ask about this pet's behavioral and medical history. After you submit this form, our client services team will call or email you to further discuss the information provided and to schedule a return appointment. Please expect to answer calls from 650-367-1405.

Surrender Request

Details
Are you the owner or regular caregiver of this pet?*

YesNo
What is your relationship to the owner?*
How long have you been caring for this pet?*
How soon do you need to rehome this pet?*
Why do you need to rehome this pet?*
Describe your current home (house, apartment, studio, etc.)*
If this pet is deemed unadoptable, would you like to be contacted?*

YesNo
Where did this pet originally come from? (found, given, shelter/rescue - specifiy which one.)*

Surrender Request

Health
Provide the name of your vet clinic (or where your pet received vaccinations):*
When was your pet last vaccinated?
Does your pet have any signficant or chronic health issues, surgeries, or current medications?*

YesNo
Please describe your pet's health issues, surgeries or medications:*
What brand of food is your pet currently eating?*
Has your rabbit received a vaccine for Rabbit hemorrhagic disease (RHDV2)?

Yes, one vaccineYes, two vaccinesNo
Has your rabbit exhibited any of the symptoms below?

YesNoNot sure
- Bleeding from nose, mouth, or anus
- Bruising, swelling
- Lethargy, weakness, collapse, inability to stand, paralysis
- Jaundice (yellow discoloration of skin, eyes, gums)
- Decreased awareness/responsiveness, vocalizations
- Difficulty breathing, nasal discharge, congestion, conjunctivitis, bluish mucous membranes
- Incoordination, abnormal body position or posture, spasms, seizures
- Fever
- Lack of appetite, weight loss, bloating, diarrhea

Surrender Request

Behavior History & Personality
Does your pet liked to be picked up?*
Does your pet like to be petted?*
Check all that describe your pet's personality.*

FriendlyShyIndependentFearfulPlayfulAffectionateAloofAggressiveOverly Reactive
What is your pet's favorite toy or activity?*
What is your pet's worst quality?*
What is your pet's best quality?*

Surrender Request

Additional Information
Please verify that you are human*
Include any additional information about your pet that would be helpful to Pets in Need or a new owner. This will help us make the best possible match for a new home.
After you submit this form, our client services team will call or email you to further discuss the information provided and to schedule a return appointment. Please expect to answer calls from 650-367-1405.
Should be Empty:

	No Reaction	Curious	Barking	Avoidant	Other
The postman or delivery person comes to your door.
Someone knocks on your door.
A visitor comes into the house.
A visitor tries to pet them inside your home.
A stranger approaches you while they are on a leash on a walk.
A stranger attempts to pet them while they are on a leash on a walk.
Someone goes near the food bowl when they are eating.
Someone tries to take away toys, chews, or anything else they value.
Someone hugs them.

Surrender Request