Create Account or Log In:
Creating an account or logging in via facebook/email will let you save your application, and allow you to access your pets medical records and other important information after you adopt or foster.
Are you the sole caregiver for the animal:
If you answered no to the above question, who else cares for this animal and in what capacity?
Name of current Veterinarian:
Contact information for current Veterinarian:
All this information is collected so that IF we can place the animal, we can place the animal properly. PLEASE TELL US THE TRUTH, we are MUCH MORE likely to help if you are truthful with us. We can tell if you're, exagerating, minimizing or lying and then we cannot help because we cannot safely place the animal in question.
Name of animal:
Date of birth (if you know):
Is your animal up to date on REQUIRED vaccines?
Is the animal spayed or neutered?
Is the animal good with cats?
If you answered that you would "explain below" above, please explain here.
Is the animal good with other DOGS?
Is the animal good with children?
Has your animal ever bit anyone?
If so how many times and what were the circumstances?
Is your dog potty trained?
Is your cat litterbox trained?
Is the dog crate trained?
Where do you leave the animal when you leave the home?
What kind of food is your animal eating?
How many times a day is your animal eating?
Are you surrendering due to MEDICAL issues?
If you chose "YES (I'll explain below)" above please explain below:
Are you surrendering due to BEHAVIORAL ISSUES?
Are you surrendering your animal for a reason OTHER THAN medical or behavioral?
If you stated that you are surrendering due to a reason OTHER THAN BEHAVIORAL OR MEDICAL please explain below:
I understand that upon giving my animal to the above named organization, that organization becomes the SOLE OWNER OF THE ANIMAL. I will make no attempt to reclaim said animal. I fully grant this organization the right to give said animal any medical treatment deemed necessary, and to possibly place the animal in a good adoptive home. Should a veterinarian determine that said animal is too ill to be treated, if necessary, I give the above named organization the right to put said animal humanely to sleep. I release the above named organization from all liability concerning the care of said animal under the agreement that the above named organization will make every attempt to provide adequate care and find a permanent home for said animal.
I HEREBY STATE THAT I AM GIVING UP MY ANIMAL OF MY OWN FREE WILL.
Please sign below: