Application for Surrender

Lab Rescue of Greater Richmond

Application for Surrender
Please note: Foster homes are limited and are prioritized for shelter dogs who are at immediate risk of euthanasia. Because of this, we may not have an available foster home for owner surrenders right away. However, we are happy to work with you to keep your dog safely in your home while we help find an adopter or until an appropriate foster home becomes available. Thank you for your understanding and for giving us the opportunity to help your dog.
Owner's Information
Owner's Name

First NameLast Name
Contact E-mail:
Cell Number:
Co-Owner's Name

First NameLast Name
Contact E-mail:
Cell Number:
Address where the dog is located

Street Address

CityState / Province

Postal / Zip Code
Are you the legal owner of the dog being surrendered?
If not the legal owner, who is the legal owner of the dog.
Legal owner;s Name and Phone Number
If not the legal owner, please explain below.
Legal Owner's Name

First NameLast Name
Legal Owner's Email
example@example.com
Dog's Information
Photos of face & body

Take photo at dog's level.
Face/head, ears photo

Upload a File
Choose a photo that **clearly** shows the dogs face/head/ears Cancelof
Standing side body/ tail photo

Upload a File
Choose a photo that clearly shows the dog standing. Cancelof
Dog's Name:
Is the dog a pure bred Lab?
If known, what is the breed mix of the dog?
Birthday, if known

MonthDayYear
Date
Age:
Weight:
Color:
Sex:
Is your female spayed?
If no, when was the start of her last heat cycle?
Is your male neutered?
How long have you owned the dog?
Where did you get the dog?
Dog's Home Life
Where does your dog stay when you are away from the home?
Comments:
How many hours is the dog home on a typical workalone day?
Where does your dog stay at night?
Comments:
Crate Behavior
Is the dog house trained?
Is your yard fenced?

Other
If yes, will the dog jump over the fence.
Comments on height and style of fence.
Has your dog ever escaped your home, yard, or leash?
If Yes, please explain
Are there other pets in the home?
Please tell us about the other pets in the home and how this dog behaves around those pets.
What is the current exercise routine? Describe a typical day for your dog.
What is the brand of dog food used and feeding schedule?
Training
Your Dog's Personality and Training
Professional Trainer's Company/Name
Type of training equipment used

Other
Comments on any of the above
The dog knows/displays the following

Other
Dog's Temperament

Other
Comments on any of the above
Dog Friendliness

Other
Please explain how your dog greets other dogs.
Appropriately sniffs ,comes in fast, growls, lunges, barks, happy and comfortable, stiffens
Cat Friendliness

Other
Is your dog good with children
Ages of children the dog has been exposed to
If children are in the home, do the children and dog interact together? Please explain how your dog reacts and interacts with children (Dog's Body Language) If not good with children, please explain behavior with kids in detail.
Has your dog ever snapped, growled, or air‑snapped at an Adult or child?
If Yes, Please Explain:
Does your dog display any resource guarding with the following. (Resource guarding refers to a dog displaying behavior (growling, snapping, etc.) intended to convince other dogs or humans to stay away from a particular treasure or “resource.”). You can also think of it as 'possessiveness.' The resource can be food, treats, toys, a place (a bed or favorite chair), or occasionally a person.

Other
If Yes, Please Explain:
Any destructive behaviors?
How does your dog behave when left alone.

How does the dog tolerate the following?

Rows	Comfortable	Tolerates	Nervous	Growls/Snaps	Unknown
Nail Trims
Grooming
Having collar /harnes put on?
Touching paws/ mouth / tail
Vet Exams

Dog's Health Information
Is the dog current on vaccines?
When was your dog's last vet visit?
Is the dog currently on Heartworm preventative?
When was preventative last given?
Date of last Heartworm test:
Flea preventative?
Does your dog take any medication? If so please list here
Stairs, wood floors,etc
Any known allergies (food or environmental) please list here
Stairs, wood floors,etc
Any previous surgeries or chronic conditions? please list here
Stairs, wood floors,etc
Is the dog Microchipped?
If Microchipped, where is the chip registered and what is the Microchip Number?
General Health Comments
Veterinary Information
Veterinarian Practice :
Veterinarian Practice Phone Number:
Veterinarian Address:
* You will need to give your veterinarian permission to speak with a LRGR volunteer.
I authorize LRGR to contact my veterinarian and obtain medical records.
If your dog is not up to date on Vaccines and/or Heartworm Test, are you able to get the dog up to date before surrendering?
I have spoken to my veterinarian and have given them permission to speak with Lab Rescue.
Reason for giving up the dog?
If there are any specific concerns or situations we should be aware of—such as housing issues, family emergencies, medical needs (yours or the dog’s), or behavioral challenges—please share them below. This information helps us better understand your situation and plan accordingly:
Will you be donating the dog's crate?
By submitting this electronic form, I acknowledge that all the information on this form is true and correct. I understand that any misrepresentation of fact may result in legal action by Lab Rescue.
Does your dog have any mobility concerns? If Yes, please explain.
Stairs, wood floors,etc
Should be Empty:

Lab Rescue of Greater Richmond

Owner's Information

Dog's Information

Photos of face & body

Dog's Home Life

Your Dog's Personality and Training

Dog's Health Information

Veterinary Information