Owner Surrender Appointment Request Form
If you have exhausted all other options and would like to make an appointment to surrender your pet, please fill out this form in its entirety.
Owner Name (*)
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Address Line 1 (*)
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Address Line 2
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City (*)
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State (*)
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Zip Code (*)
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Phone Number (*)
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Email Address (*)
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Pet Name (*)
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Type of Animal (*)


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Gender (*)
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What breed? (*)
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Age of the animal (*)
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How long have you had the pet? (*)
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Where did you get the pet from originally? (*)
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Is the animal spayed or neutered? (*)


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Is the animal up to date on shots? (*)


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Is the animal sick, injured or does it have any health problems? If so, please describe. (*)
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Please describe the pets temperament (*)



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Has the animal ever lived with other pets? (*)


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Is the pet good with children? (*)


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Is the pet good with dogs? (*)


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Is the pet good with cats? (*)


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Where does the animal stay during the day? (*)
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Where does the animal stay at night? (*)
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Is it housebroken or does it use a litter box? (*)

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Has the pet ever shown signs of aggression towards people? If yes, please describe. (*)
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Has the pet bitten anyone in the last 10 days? (*)


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Do you currently have other pets at home? (*)

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Why do you want to give this animal up? Please describe in detail. (*)
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Upload a photo of the pet you want to surrender
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