Dog Surrender Form

Dog Surrender Form

Yolo County Animal Services
Date

MonthDayYear
Date
Do we have your permission to post a rehoming animal bio with our partners?
Owner's Name

First NameLast Name
Owner's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Dog's Name:
Please upload a picture of your dog.

Cancelof
Dog's Breed:
Dog's Age:
Dog's Color:
Dog's Gender
Is your dog spayed or neutered
Is your dog current on vaccines
How long have you had the dog?
Where did you get the dog?
Reason for Surrender/Return
If you selected behavior, would training resources help you keep the animal in your home?
If other please describe
If you are surrendering because of medical reasons please describe the dog's symptoms and provide your Veterinarian's contact information below:
Has your dog bitten a person?
If your dog has bitten please describe the bite. Did it break the skin? Did the victim require stitches? What were the circumstances behind the bite?
Has your dog shown any of the following negative behavior

Other
If your dog has displayed any of the above negative behaviors please describe.
How would you describe your dog's behavior around childern?
Where did you keep your dog
Is your dog potty trained?
Is your dog crate-trained?
Does your dog allow people to take food and toys away from them?
When you have visitors to your house how does your dog behave? Please explain. (For example: We keep it away from visitors or It allows visitors to pet he/she etc.)
Have you tried to rehome this pet on your own
If yes, please describe what resources you used to rehome your dog i.e. Facebook, Craigslist, Nextdoor, family members, etc.
Has your dog been seen by a veterinarian?
If yes, please provide the vets contact information.
Has your dog lived with any of the following?
Is there anything else you think we should know about your dog?
Signature
Should be Empty: