Owner Surrender Form

Owners Information

This section is for the owner of animal only. If you are a next of kin with ownership of a deceased/incarcerated/hospitalized/displaced relatives pet, please use your information. Any questions, please contact us at cvasmgr@cvas-pets.org.
Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Animal(s) Obtained

If there are multiple pets with different locations of where they came from, please list: Pet Name - Place Obtained
Where did you obtain the pet(s)?*
Ex: Shelter Name (i.e. CVAS, Antietam, Washington County, etc.), Rescue Name (i.e. Sperenza, Knick Knack, etc.), Online, Farm, Family/Friend, etc..

Reasoning

Please be honest and do not make it vague - the more detailed and truthful you are, the smoother the process of surrendering your pet will be.
What is the reason for rehoming your pet(s)?*
Please be honest and do not make it vague - the more detailed and truthful you are, the smoother the process of surrendering your pet will be.

Pet Information

Be as detailed as you can in the responses, as this will both help the Management Team know the pet, and also potentially expedite the process.

If there are multiple pets, select the +Add Row until every pet has been added and described
- Do not just summarize the animals into one slot. This will not be processed.
- If you do not complete this section completely, we will be unable to process your request.
If there are any questions, please reach out to us at 717-263-5791 before submitting.
Pet Information*
If able, attach a photo of the pet(s) needing surrendered. This will help in the processing of your request.

Additional Information

If there is anything else you would like to provide, either on your situation, or on the pet(s), please feel free to write below. We always appreciate as much information as you are able to give, as this helps us greatly in understanding the pet(s) and the situation.
Is there any other information you would like to provide that was not listed above?
Should be Empty:

Owners Information