Surrender Application

Please upload a picture of the animal.

What type of animal?

Pet's Gender

Breed

Spayed/Neuter?

Pet's Name

Pet's Date of Birth

Is your pet microchipped?

Why are you surrendering the pet?

Vet Name

Vet Address

Vet Phone Number

Has your pet ever had surgery?

If yes, please explain

Has your pet been to the vet for routine care (annual check ups, vaccinations, etc)?

If you have any vet records, will you be able to supply them to us?

How does your pet behave during vet visits?

Does your pet need to be muzzled at the vet?

Is there anything else we need to know about the pet's medical history?

How does your pet behave towards men?

How does your pet behave towards women?

How does your pet behave towards children?

How does your pet behave towards dogs?

How does your pet behave towards cats?

How does your pet behave towards strangers?

Can you please tell us about any bad habits or fears? (chewing shoes, jumping, hiding during storms)

How does the animal react when you or another family member goes to pet him/her or touch a bone, rawhide, treat, while chewing/eating?

How does the animal react when you or another family member goes to pet him/her or touch the food bowl while eating?

How does the animal react when you or another family member goes to pet him/her or touch a stolen food item?

How does the animal react when you or another family member goes to pet him/her or touch a stolen object (show, sock, tissue, etc)?

How does the animal react when you or another family member goes to pet him/her or touch a toy in his/her mouth?

How does the animal react when you or another family member goes to pet him/her or move him/her while sleeping?

How does the animal react when you or another family member goes to push him/her off of furniture?

How does the animal react when you or another family member goes to approach him/her while next to another?

How does your pet react to hugging and petting?

Are there any areas of your pet's body that they DO NOT like to be touched? If so, what is their reaction?

How does your animal react to bathing and grooming?

What kind of toys does your pet enjoy?

How does your pet react to being in the car?

What commands/words does your pet know?

Are there any tricks/habits that your pet knows?

Are there any other behavioral problems we should know about?

Does your pet go outside to use the restroom?

If yes, how many times does the animal need to go out?

If yes, how does the animal let you know that they need to go out?

Does your pet have accidents in the house?

If yes,

If yes, how often?

Is the animal crate trained?

How long can your pet "hold it" if they go outside to use the restroom?

How long is the animal left alone without people?

When home alone, does your animal do any of the following?

When you are home WITH your pet, do they do any of the following?

Is your pet permitted to sleep on furniture?

I am surrendering the pet(s) to Second Chance Animal Rescue and Sanctuary, and no longer will have any control or responsibility over the surrendered pet(s). By signing below, I have filled out this application to the best of my knowledge.