Owned Pet Surrender Form

  • Owned Pet Surrender Form

    FosterDocHouston Dog Rescue

  • Your Info

  • Format: (000) 000-0000.

  • Dog & Household Info

  • Sex:*
  • What other animals has your pet lived with?*

  • Behavior

  • If your pet has been in contact with other animals in the past or currently, what was his/her reaction?*
  • What is your pet's reaction to you and other familiar people?*
  • What is your pet's reaction to new/unfamiliar people?*
  • Is your pet potty/house trained?*
  • How many hours per day is your pet left alone on average?*
  • When left alone, where is your pet kept?*
  • Is your pet fearful of anything, such as thunder, loud noises, men, etc?*
  • Where does your pet sleep overnight?*
  • What commands does your pet know?*
  • How does your pet behave on a leash?*
  • Does your pet have any problems riding in a car (anxiety, restless, tries to escape)?*
  • Has your pet ever escaped from/attempted to escape from your property?*
  • Has your pet ever attacked or bitten a person?*
  • Has your pet ever attacked or bitten another dog?*
  • Has your pet ever attacked or bitten any other type of animal?*

  • Medical

  • Does your pet see a veterinarian at least once a year?*
  • Are your pet's vaccinations up to date?*
  • Has your pet been tested for heartworms in the past year?*
  • Has your pet consistently been on monthly heartworm prevention?*
  • Is your pet microchipped?*
  • Does your pet have to be muzzled at the vet?*

  • Other

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  • By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

    I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the denial of any pet submitted as an intake request by me.

    I certify that the above information is correct, and I understand that the information will be verified.

    I understand that by submitting this form electronically, I agree to release and to hold harmless FosterDocHouston Dog Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the surrendered dog.

    I accept full responsibility for the dog(s) actions at all times, and release FosterDocHouston Dog Rescue from any liabilities or damages that may be incurred because of surrendering such dog(s).

    I agree to have FosterDocHouston Dog Rescue complete reference call checks and conduct a home visit inspection and/or home facetime to be able to approve my surrender application.

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