Animal Surrender Form

Animal Surrender Form

Please fill in all sections of this form or your application be void.
Please note that we no longer operate a waiting list. We triage all forms you will be contacted if we have suitable space.

Once you have received a reply from us, we require a response within seven days otherwise we will remove you from the application process and you will have to resubmit the surrender form.

We recommend that you contact as many rescues as possible. Further a field if necessary.

https://catchat.org/
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number*
Email*
example@example.com
Please give details of the animal you wish to surrender
Name and Type of animal*
eg cat / dog
Specific breed (if any)*
eg british blue / corgi
Name of Animal*
Age of Animal*
Is the animal Male or Female?*
Is the animal Neutered or Unneutered*
Is the animal Microchipped?*
Please confirm microchip number.
Is the animal up to date with vaccinations?*
This means within the last 12 months.
If vaccinated, what date was the last vaccinations?*

MonthDayYear
Date
Vet details (name and address)*
We ask for a vet history for all cats. Can you provide this?*
Please get in touch with your vets to email it to us. Catteam.animalsamaritans@gmail.com
Please confirm any known medical issues. Please write 'NONE' if you answered no to the previous question*
Is the animal used to / comfortable in the company of other cats?*
Is the animal used to / comfortable in the company of dogs?*
Is the animal used to / comfortable in the company of children?*
Is the animal used to a garden or has it been an 'indoor' pet only?*
We do not provide a collection service. If you secure a rescue space you will be offered an appointment at one of our vets in DA7/DA11/ME16 to surrender your animal. Please confirm you understand this is the surrender process*
Detailed reason for surrendering the animal*
eg moving home / owner died etc
If you are not the registered owner you will need to confirm your relationship to owner and if you have authority to surrender the animal.
I confirm that all information on this form is true and complete. I confirm that by selecting YES, this will act as a confirmation signature.*
Once you have received a reply from us, we expect a response within seven days otherwise we will remove you from the application process and you will have to resubmit the surrender form
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