FPAF Owner Surrender Form

Owner Surrender Form

Please complete one form for each animal being surrendered. Pet Angel Fund makes every attempt to find safe and loving homes for the adoptable dogs surrendered to us. Please fill out the form entirely. If admitted, the detailed and accurate information you provide makes it easier for us to place your dog in an appropriate home based on its personality and needs.

Failure to fill out this form can result in our inability to accept your dog into our rescue.

Name:*

Address:*

City/State:*

Zip:*

Contact Number:*

Work Phone:

Email Address:*

example@example.com

Pet's Name / Nicknames:*

Male/Female:*

Age:*

Breed:*

Color/Marking/Scars*

Is your dog microchipped? If yes, what company?

Are you transferring any kind of support with this dog?

Where did you get this dog from?*

If you answered breeder or rescue, have you contacted them about returning?

How long have you owned your dog?*

Why are you surrendering your dog?*

Is this dog training in any other language than English? If yes, what?

Is your dog spayed or neutered? Yes No*

What type of dog food are you feeding?

How much are you feeding and how often? Example: 2 cups 2 times a day

Is your dog destructive when left alone? Yes No

If yes, please explain:

Is your dog house trained?

Is your dog kennel/crate trained?

What cues does your dog know, if any?

Has your dog had previous training? Yes No

What veterinarian does your dog go to?

When was your dog last at the vet?

When was your dog last vaccinated?

Does your dog have any known health related issues? Yes / No

If Yes please explain.

Does your dog have any allergies?

Is your dog on any medications or supplements? If so, what?

Has your dog been on Heartworm preventative? Yes / No What kind?

When was your dog last tested for Heartworms?

What was the test result? Positive / Negative?

When was it last given?

Does your dog currently live with children? Yes / No If yes, what ages?

Please describe your dog's experience with children:

To strangers?

To visitors in the home?

If you try to take away a toy or bone?

If you take your dog's food while eating?

Does your dog have any food aggression? Yes / No

If your dog is disturbed while sleeping?

Any additional comments:

Does your dog live with other dogs? Yes / No How many?

If Yes, What are the age/sex/breeds ?

Does your dog get along with other dogs? Yes / No

If yes, please explain your dogs experience with other dogs:

If no, please explain:

Does your dog get along with other type animals? Yes / No

Does your dog live with cats? Yes /No

If yes, please explain your dog's behavior with cats:

Does your dog have behavior issues? Yes / No

If yes, please explain:

Does your dog have any fears? Yes /No

If yes, please explain:

How does your dog react: When being seen by a veterinarian?

When being groomed?

To having his/her nails trimmed?

Has your dog ever bitten anyone? Yes / No*

If yes, did it break skin? Yes No

Did the bite require a hospital visit?

Was a bite report filed? Yes/ No

Please explain the bite incident:

What is the date of the last bite?

Has your dog ever bit another animal?*

How severe was the bite? Did it result in death?

Has your dog been attacked by another animal?*

If yes, please describe the incident and severity of injury.

Please list a few things you like best about your dog:

Please take some time and tell us anything else you think we or a potential adopter should know about this dog, the more we know the better it will help the dog!

By signing this form, I state that I am the dog's legal owner, who is the Animal Surrender Form's subject. To my knowledge, no other person has a right to this animal. I hereby surrender all rights to this animal. I understand that once I relinquish this animal, it will not be available to be returned, nor will I retain my legal right to the dog, nor do I have any right to inquire about the new adopter or location of the animal once it's been placed. Any attempts to contact the new owner without permission will be viewed as harassment, and I can be charged accordingly under the provisions of the law.

I also understand that is my responsiblity, that if my dog is microchipped I am required to contact the registered organization and transer my dog out of my name and in "Fayetteville Pets Angel Fund" as the new registered owner with the phone number 910-758-1556 and email fayettevillepetsangelfund@gmail.com

I have read and understand the terms of this Animal Surrender Form.

Signature*

Date

More Details about Your Dog

How Does Your Dog React?