Surrender a Dog
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
What is your address?
What time of day is a good time to contact you via phone?
*
Why do you want to surrender your dog/puppy?
*
What is your dog/puppy's name?
How old is your dog/puppy?
*
What breed and sex is your dog/puppy?
*
Has your dog/puppy bit another person or dog?
*
Please Select
Yes
No
Is the dog/puppy spayed/neutered?
*
Please Select
Yes
No
Is the dog/puppy up to date on its rabies vaccination?
*
Please Select
Yes
No
Unsure
Is the dog/puppy up to date on its distemper vaccination?
*
Please Select
Yes
No
Unsure
Does the dog/puppy have any medical issues? If so, please explain.
*
This would include any special diets, allergies, etc.
Does the dog/puppy resource guard with other dogs or people? If so, please go into more detail when they resource guard, who and what they resource guard.
*
Does the dog/puppy have any anxieties? If so, please explain in what situations they display this behavior.
*
Submit
Should be Empty: