Herp Habitat Surrender Form

PLEASE NOTE: Herp Habitat Rescue & Sacntuary does not take in aquatic turtles, large lizards, large tortoises, or snakes over 6ft. Herp Habitat is not a licensed wildlife sanctuary and we do not take native species.

Sick animals are assessed and accepted or denied on a case-by-case basis. We are not a rehabilitation center. For urgent medical needs please seek a qualified veterinarian.

If you are unsure or have questions, please reach out to info@herphabitat.org.
Your Basic Info
Please enter your legal name*

First NameLast Name
I am 18 years of age or older*

YesNo
I am 18 years of age or older (If under 18 years old you must get the name and signature of a parent or legal guardian)*

Yes
Your Email address*
example@example.com
Your phone number*
Please enter a valid phone number.
Animal Surrender Info
Type of animal*
Morph (if applicable)
Animal's name
Sex
Age*
How long have you had them*
Where did you get them*
What do they eat*
What supplements do they get*
Was UVB provided? If so what kind of bulb
What size enclosure were they kept in
Cold side temperature
Hot side temperature
What substrate/bedding were they on
Were they cohabitated with other animals?
Photos of animal

Cancelof
Health & history

Please answer truthfully to the best of your knowledge. Whether or not we accept sick animals depends on if we have the resources and finances to help the animal. Withholding or misrepresenting health information may result in your surrender being declined. For urgent health concerns, please seek a qualified veterinarian.
Are you surrendering due to health concerns?*

YesNo
Have you sought veterinary care for this animal? If yes, please provide the vet clinic and outcome. If no, please explain why.
Health status (check all that apply)*

Appears healthy, eating, and activeNot eating or losing weightLow energyStuck shedMetabolic bone diseaseVisible minor injury (e.g., scratch, missing nail, healed past injury)Visible major injury (e.g., broken bones, necrotic tissue, noticeable swelling)AggressionRespiratory concerns (e.g., wheezing, bubbles from nose/mouth)Other
Describe any current and/or past health concerns
Notes (behavior, likes, dislikes, etc.)
Reason for surrendering
Confirmation

Confirmation and surrender appointment info
What city do you live in? (This helps us set up the surrender drop off appointment)*
Would you like to donate the enclosure? (We do not always accept enclosures, it is case-by-case)*

YesNoMaybe, it depends
How would you like us to reach out about the next step?*

TextEmail
Surrender Fee*

I agree to pay the $50 surrender fee after the surrender drop off takes place to assure my animal receives the care they need and to help offset costs from food, electricity, supplies, and vet billsDue to financial hardship I am unable to pay the $50 surrender fee
I confirm that I am the legal owner of the animal described in this surrender form and have the authority to surrender the animal to Herp Habitat Rescue & Sanctuary, Inc.*

Agree
By signing this agreement, I, the undersigned, hereby voluntarily surrender the animal described above to Herp Habitat, Rescue & Sanctuary. I understand that by surrendering this animal, I am relinquishing all rights, ownership, and interest in the animal to Herp Habitat, Rescue & Sanctuary, and that this transfer is permanent.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Your Basic Info

Animal Surrender Info

Health & history

Confirmation