SURRENDER

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Personal Information

DOG'S BASIC INFORMATION

WE WILL NEED ACCESS TO YOUR VETERINARIAN'S INFORMATION TO CONTACT THEM IN ORDER TO CONFIRM MEDICAL STATUS. PLEASE GIVE YOUR VETERINARIAN'S OFFICE PERMISSION TO RELEASE INFORMATION TO OUR SHELTER WHEN WE MAKE THE CONTACT.
THIS INCLUDES ANY DIAGNOSIS BY THE VET (EPILEPSY, FOOD ALLERGY, NEEDED MEDICATIONS, ETC.), PLEASE INCLUDE AS MUCH INFORMATION AS POSSIBLE.
PLEASE EXPLAIN REASON AS IN DEPTH AS POSSIBLE.
Exact or best estimate

BEHAVIORAL QUESTIONS

IN DEPTH PLEASE

PERSONALITY/TEMPERAMENT

ADDITIONAL INFORMATION

BLUE CHIP NOTE

While we try our best to assist each family and animal in need, we can not guarentee that your animal will be accepted into our shelter. We reserve the right to deny a surrender form. Please call 570-333-5265 if you have not heard from us within 7-14 days of surrender form completion.
 

please note - Completing this form does NOT guarantee that we can accept your animal as a surrender. 


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