Surrender Questionnaire

Surrender Questionnaire

Type N/A for any questions you are unsure of.
Name

First NameLast Name
Date

MonthDayYear
Date
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pet Name
Age/DOB
Markings/Color
Breed
Sex
Approx. Weight
Mircrochipped?
Microchip ID #
Is dog neutered/spayed?
Why are you surrendering this dog? (Please provide as much information as you can.)
How long have you owned the dog?
Where did you get the dog?
Have you asked friends or family for assistance in finding a home for your pet? If yes, please explain
Has the dog ever bitten or attempted to bite a person?
If yes, who was bitten and where?
Date of incident

MonthDayYear
Date
Please explain the circumstances
I understand that if my dog is a bite risk, he/she may be returned to me depending on the severity of his/her case.
Has the dog ever
If yes, please explain the circumstances
Name of dog's veterinarian

First NameLast Name
Vet's Phone Number

Area CodePhone Number
Date of last vet visit

MonthDayYear
Date
Reason for last vet visit
Is the dog current on vaccinations?
If no, explain
Current illnesses, skin conditions, etc
Current medications being given and why
Brand and type of Heartworm Prevention given
Brand and type of Flea/Tick Prevention given
Please list any past or present injuries, other medical history, physical condition, allergies, restrictions, etc
If you have documentation or the pets previous vaccinations, vet visits, etc, please email a copy to furangelfoundation@gmail.com
Has your pet had a fecal test done in the last 30 days?
Results?
Have you noticed any
Medication given
Is the dog potty trained?
Please explain (pad, outside)
Is the dog crate trained?
Please explain
Current food
Any other details (good w/other dogs, kids, temperament, special needs, brushing teeth, exercise, traumatic experiences, etc.) and the frequency if applicable
Digital Signature

First NameLast Name
I understand that due to high volume of inquiries FAF cannot guarantee if or when they can take in my pet, however, FAF will contact me as soon as space becomes available. I understand it is my responsibility to follow up with FAF for updates on availability
If your pet is experiencing behavioral or medical issues ask your vet for assistance in managing these issues, and then reach out to a qualified trainer or behaviorist. See our website for resources.
Additional resources to research to see if space is immediately available for your pet:

Hawaii Dog Foundation
OSPCA
Dog People of Oahu
PAWS of Hawaii

The submission of this form does not commit you or FAF to any binding agreement.

Fur-AngelFoundation | 590 Farrington Hwy #524-224,Kapolei,HI 96707
furangelfoundation@gmail.com | Ph:808.763.8662
Photo of Dog

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Attach any medical docs for dog

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Click here to make a surrender donation.
Your donation covers a portion of medical care, food, and supplies.
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