Herp Habitat Surrender Form

PLEASE NOTE: Herp Habitat Rescue & Sacntuary is currently ONLY ACCEPTING SMALL AND MEDIUM SNAKES. We are temporarily pausing the intake of lizards, turtles, and amphibians. 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
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)
Your Email address
example@example.com
Your phone number
Please enter a valid phone number.Format: (000) 000-0000.
Animal Surrender Info
Type of animal
NOTE: We are currently ONLY accepting snake surrenders
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
What size enclosure were they kept in
What substrate/bedding were they on
Were they cohabitated with other animals?
Photos of animal

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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?
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)
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)
How would you like us to reach out about the next step?
If we are full, would you like to be added to our waitlist? (We will notify you)

Depends
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.
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
Date

MonthDayYear
Date
Should be Empty:

Your Basic Info

Animal Surrender Info

Health & history

Confirmation