Surrender Request Form
Pet surrenders are only scheduled as space allows so we do suggest that you attempt to rehome on your own when possible. Resources to help keep your pet or rehome responsibly can be found at: https://www.kalcounty.com/ac/Animal_Resources.htm .
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
What type of notification would you prefer for appointment details or further questions to be relayed?
*
Please Select
By Phone
By Email
Date of Birth
*
Please select a month
January
February
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Month
Please select a day
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Day
Please select a year
2024
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Year
Address (Must Match DL/ID Card)
*
Street Address
Street Address Line 2
City
State
Zip Code
Physical Address (If Different than ID)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you surrendering this pet(s) due to a bite, citation, or notice letter from the County, or other legal process?
*
Please Select
Yes
No
Not Sure
If you stated yes above, which reason
Bit a Person (Within the past 10 days)
Bit a Person (More than 10 days ago)
Citation or Notice
Eviction/Loss of Residence
Other
Please provide in detail the reason(s) you are surrendering your pet?
*
The more information listed the better we are able to serve you and your pet.
What resources do you need to prevent you from surrendering your pet(s)?
*
What is your pet's name?
*
What type of pet are you surrendering?
*
Dog
Cat
Other
What is the age of your pet?
*
What Breed(s) is your pet if known.
Is your pet sterilized (fixed)?
*
Please Select
Yes it is fixed
No it is not fixed
I am not sure
How long have you had the pet?
*
3 weeks or less
1-6 months
6 months to 1 year
More than a year
How did you acquire the pet?
*
Kalamazoo Animal Services
Other Shelter/Rescue
Breeder/ Pet Store
Other
If obtained through Shelter/ Rescue, please name which below:
Many rescues groups and private shelters have in their contracts that you must return the animal to them if needing to surrender. If this is your situation you should reach out to them first.
Is your pet microchipped?
*
Please Select
Yes, it is microchipped
No, It is not microchipped
I'm not sure
Is your pet sick or injured?
*
Please Select
Yes, it is sick
Yes it is injured
No, it is not sick or injured
Please list any known medical conditions:
Please select a good, clear, picture of your pet. Then click the upload button to upload picture. Note: the picture will be available on the website and better pictures may result in sooner appointments.
*
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I understand that owner surrenders are by appointment only and surrender fees will apply at time of intake. $20 Per Cat, $30 Per Dog
*
I understand
It is my responsibility to provide transportation for the pet to our location at the appointed time of surrender. KCASE staff are not able to pick up owner surrendered pets.
*
I understand
Kalamazoo County Animal Services & Enforcement is not a "no kill" shelter. Upon physical surrender, ownership is immediately transferred to Kalamazoo County Animal Services & Enforcement and your pet could be euthanized.
*
I understand
By submitting this request, I am certifying that I am the legal owner of the pet I am turning in and that I am relinquishing all ownership rights to the described pet to Kalamazoo County Animal Services & Enforcement. The pet described could be: placed for adoption, euthanized, or transferred to another shelter/animal welfare group.
*
I understand
If multiple individuals own the animal (I.e. husband-wife; adult child-parent) or might have an ownership interest in the animal, I have their consent to surrender the animal
*
Yes, I have consent
No, I do not have consent
Submit
Should be Empty: