• Senior Dog Sanctuary Surrender Form

    Senior Dog Sanctuary Surrender Form

  • Date
     - -
  •  -
  • Please select which options you've already tried in an effort to place your dog:*
  • When does your dog need placement?*
     - -
  • Was Animal Control Involved?
  • Did the incident break the skin?
  • Has your dog ever:*
  • Is your dog currently vaccinated?*

  • Is your dog current on heartworm testing/preventatives?*

  • Check all of the following that describe your dog*
  • Is your dog housetrained? (Select all that apply)*
  • Is your dog crate trained? (Select all that apply)*
  • Describe how your dog has done in a boarding facility and/or daycare:*
  • Can your dog go up and/or down stairs?*
  • What is your dog's history with children?*
  • Would you recommend your dog live with children in the future?*

  • What is your dog's history with other dogs?*
  • Would you recommend your dog live with dogs in the future?*

  • Has your dog lived with or been exposed to cats?*
  • Would you recommend your dog live with cats in the future?*

  • How does your dog travel in a car?*

  • How is their appetite? (Select all that apply)*
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  • My signature below certifies that I am the owner of (or have the authority to surrender) the dog described above. I certify that to the best of my knowledge I have disclosed all information about the dog concerning health, behavior, history, and anything else that may affect the safe placement of the dog in a new home and that all statements made above are true and correct. I understand once my dog is accepted, the Senior Dog Sanctuary of MD shall have sole and exclusive legal rights to make all outcome decisions deemed appropriate and that SDS is not obligated to communicate the outcome of the dog to me or any other party. 

  • **IMPORTANT - PLEASE READ FOR NEXT STEPS FOLLOWING SUBMISSION OF APPLICATION**

    We ask for your patience as we receive a large number of requests on a daily basis. 
    We will respond to your application within 5 days. 

    **Check your inbox + spam folder for a response to your application from intake@sdsanctuary.com**

    We are proud to provide a compassionate environment with the best possible medical care for the senior dogs who join our Sanctuary.  This is made possible through donations of our supporters. If you are able, we appreciate any donations made to our cause!

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