Owner Surrender Information Form

Pet name:

Purebred or mix:

Color:

Age:

Sex:

Is the pet spayed/neutered:

Is the pet micro chipped?: If so, please send any paperwork you have on it.

Good with kids?:

Good with other dogs?:

Good with cats?:

Any obedience training? If so, please specify the commands he/she knows.

Crate trained?:

Housebroken?:

What food is he/she currently fed?:

How much?:

Is the dog on any medication?:

What amount of exercise does the pet get daily?:

Do they swim?:

Do they walk well on a leash?:

Where was the dog during the day while you were at work?:

Where was the dog kept at night?:

Where was the dog when you were home?:

What is the reason you are giving the pet up?:

Please list any other information about the pet that would be useful for our foster homes or potential new adoptive families to know. Please list both good and bad things that we should know.