Owner Surrender Intake Request

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Personal Information

About the Pet

Medical History

Pet's Temperment

Acknowledgement

-You certify that you are the righful owner of the pet.

-You certify the answers you provided are truthful to the best of your knowledge.

-You certify the pet has not bitten a human or another animal within the past 10 days.

If your application is accepted

-You surrender to Town and Country Humand Society any and all rights to the animal(s) and certify that no other person has the right of property to the animal(s).

-You understand that once you relinquish the animal(s), the animal(s) will not be available to be returned to you.

-You agree to make a donation to help cover the care of the surrendered animal(s).


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