• Surrender Form

    ALL QUESTIONS MUST BE ANSWERED OR FORM WILL BE RETURNED FOR COMPLETION. TYPE IN N/A IF A QUESTION DOES NOT APPLY.
  • Date of Submisson*
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  • Dog's Information

  • If a Dachshund mix, name of breed mixed with:

  • Owner's Information

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  • Veterinary and Medical Information

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  • Is the dog spayed/neutered?*
  • If not, will you have this done?

  • Spay/Neuter Fee:

    If the dog is NOT spayed or neutered at the time of surrender, a $100 fee may be charged unless the dog is of advanced age or has a medical issue which precludes the procedure. The fee MUST be paid at the time of surrender, unless other arrangements have been made in advance.
  • Please provide the dates of the last vaccinations:*
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  • Is the dog on Heartworm prevention?*

  • Behavior Profile

    It is important that you describe any and all of the dog's behavioral qualities and problems. To place your dog in a permanent and loving home, we need to know as much as possible about his/her good and bad traits.
  • Is the dog housebroken:*
  • Please complete the following:*
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  • Additional information on the dog's behavior:*
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  • How is the dog with cats?*
  • How is the dog with other dogs?*
  • How is the dog with children:*
  • How is the dog with adults?*
  • Has the dog ever bitten a person?*
  • If yes, is Animal Control or the Police invlolved?*
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  • Terms and Conditions

  • By checking the following box and/or typing or signing my name, I certify that...

    • I am the owner of this animal and hereby relinquesh all present and future rights and claims to the subject animals, and to all possessions transferred with it to Dachshund Rescue of Northern California (DRNC). 
    • I have fully informed DRNC of all known or suspected medical and/or behavioral problems and concerns with this animal.
    • I have indicatd all information possible to ensure the animal's continued happiness and welfare. 
    • I understand that I may not be provided with information about this animal's whereabouts once surrendered. 
    • I give the aforementioned Veterinarian, Clinic, and any other Veterinarian/Clinic that has treated this animal for any reason, and their staff permission to discuss this animal with DRNC and provide copies of any and all paperwork with regard to this animal. 
  • I agree to the above Terms and Conditions/Certifications*

  • BEFORE YOU SUBMIT - did you answere all the questions? 

    Please check because incomplete forms will be kicked back for completion and delay the process. If a question does not apply to your dog, just type n/a.

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