Owner Surrender Form

Owner Surrender Form

We understand that the decision to surrender your pet is difficult to make. Once this form is submitted, an intake team member will contact you about possible placement for your pet(s). We encourage you to explore alternate placement options via friends and family, social media, and resources listed on our website -> https://www.lafourchegov.org/animal-shelter
Owner Information
First & Last Name*
Date of Birth*

MonthDayYear
Date
Drivers License Number*
Address*
City*
Zip Code*
Phone Number *
Alternate Phone Number*
Email Address*
example@example.com
Provide proof of residency in Lafourche Parish here. Driver's License or ID required**

Upload a water bill or rental agreement in your name if your ID doesn't have a Lafourche Parish Address.
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Pet Information
Name*
Age/ Date of Birth*
Breed/ Mix*
Where did you get this pet from?*
How long have you been their owner?*
Why are you looking to rehome your pet*
Check the corresponding boxes to inform Lafourche Parish Animal Shelter's staff of your pet's disposition. This information assists with finding the next best placement for your pet.
Is / Does your dog...
Established with a Veterinarian?*

YesNoUnknown
Spayed or Neutered?*

YesNoUnknown
Microchipped?*

YesNoUnknown
UTD on a heartworm preventative?*

YesNoUnknown
Know any cues?*

YesNoUnknown
Potty / House trained?*

YesNoUnknown
Content in crate or kennel?*

YesNoUnknown
An escape artist?*

YesNoUnknown
Destructive in the home? (ex. furniture, toys, beds)*

YesNoUnknown
Scared of bad weather?*

YesNoUnknown
Nervous in the car/ carsick?*

YesNoUnknown
Reactive when on a leash?*

YesNoUnknown
Happy around small children?*

YesNoUnknown
Happy around older children?*

YesNoUnknown
Protective of their food?*

YesNoUnknown
Protective of their toys?*

YesNoUnknown
Protective of their bed/ space?*

YesNoUnknown
Protective of their siblings (if any)?*

YesNoUnknown
Protective of their handler?*

YesNoUnknown
Dog to dog behavior: Has your dog...
Ever lived with other dogs?*

YesNoUnknown
Coexisted with dogs smaller than them?*

YesNoUnknown
Coexisted with dogs larger than them?*

YesNoUnknown
Ever injured another dog?*

YesNoUnknown
Dog to cat behavior: Has your dog...
Ever lived with cats?*

YesNoUnknown
Ever injured a cat?*

YesNoUnknown
Dog to human behavior: Has your dog...
Been fearful of children?*

YesNoUnknown
Been fearful of men?*

YesNoUnknown
Been fearful of women?*

YesNoUnknown
Enjoyed playing with toys?*

YesNoUnknown
Enjoyed treats?*

YesNoUnknown
Ever injured a person?*

YesNoUnknown
If you answered yes to any of the above questions, please elaborate here. Also note any and all good qualities or information to pass to their new home.
Upload a photo of your pet.*

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Should be Empty:

Owner Surrender Form

Owner Information

Pet Information

Is / Does your dog...

Dog to dog behavior: Has your dog...

Dog to cat behavior: Has your dog...

Dog to human behavior: Has your dog...