Owner Surrender Form

Owner Surrender Form

We understand that deciding to surrender your dog is one of the hardest choices a pet parent can face. Please complete this form as thoroughly as possible so we can understand your dog’s needs and ensure a smooth, caring transition. IMPORTANT: Surrendering your dog is an irrevocable decision, and ownership rights are released upon surrender. Milo’s Dog Rescue of South Florida cannot return dogs to the surrendering owner, but we will provide a safe, loving environment and do everything possible to find the perfect forever home. We know this process can be emotional, and our team is here to support you and your pet every step of the way. Once your form is submitted, a representative from Milo’s Dog Rescue of South Florida will contact you as soon as possible to guide you through the next steps and answer any questions. Thank you for entrusting us with your beloved companion — our priority is to provide them with love, care, and a safe future.
YOUR INFORMATION
Your Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Driver License Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reason for Surrender
How long have you had this pet?
Where did you get this pet?
PET'S INFORMATION
Pet's Name
Breed
Pet's Date of Birth or Age
Current Weight
Gender
Is your pet Spayed/Neutered?
Is your pet microchip?
Microchip Number? If not microchipped put N/A
What type of food do you feed your pet? Or treats this pet particulary likes?
Your current Veterinary Clinic:
Breed
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PET'S MEDICAL INFORMATION
Does this pet has/had any known medical issues?
If Yes, please explain
Is your pet up-to-date on vaccines
If Other, please explain
Is your pet up-to-date on heartworm prevention?
Is your pet heartworm negative?
Other medical information you want to share with us?
PET'S BEHAVIORAL INFORMATION
Does your pet have any of the following behavior issues? Please explain each issue (please be honest, it will let us know what things we should work on with the pet).
Has this dog bitten in the last 14 days?
If Yes, please explain
Does this pet gets along with other dogs?
Does this pet gets along with other cats and/or other small animals?
Does this pet has any aggression or fear with certain groups of people?
If Other, please explain
Does this pet has any of the below behavioral issues,? Select all that apply.
Please explain:
Has this dog ever killed or injured another animal?
If yes, please explain:
Upload Pictures of your Pet

Cancelof
Ownership Release Acknowledgment

By surrendering your animal to Milo’s Dog Rescue of South Florida, you understand and agree that you are permanently and irrevocably giving up all ownership rights and claims to this animal.

Once the animal is surrendered, Milo’s Dog Rescue of South Florida assumes full ownership and responsibility for the animal and will make all decisions regarding their care, medical treatment, placement, and future.

Our goal is always to place animals in safe, loving homes whenever possible. However, every animal will undergo an evaluation and temperament assessment after intake to determine if they are suitable for adoption. While we strive to find homes for all animals in our care, we cannot guarantee that every surrendered animal will be placed for adoption.

By signing this form, you acknowledge that you understand and agree to these terms.
Are you willing to make a donation to Milo's Dog Rescue of South Florida to help us take care of the pet you are surrendering? (Milo's Dog Rescue is dependent on donation to provide the necessary health care needs to our rescues).
If Yes, please make a donation via Zelle = 954-628-2175 or Vemno @milosrescue
Date of Surrender

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty: