Petstablished | Manage your Animal Welfare Organization (AWO) with our easy-to-use software.

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* First name

* Last name

* Email

* Phone

Cell number

* Address one

Address two

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

What kind of animal(s) are you looking to surrender to KPAL Rescue?

DogCatSmall Animal (Hamster, Gerbil, Guinea Pig, etc.)FishBirdReptile/AmphibianFarm Animal

What breed is this animal?

What size is this animal?

What is the animal's name?

Please attach a photo of the animal.

Why are you looking to surrender/rehome this animal?

Is this animal a male or female?

MaleFemaleI'm not sure

How old is the animal?

Is this animal up-to-date on vaccinations?

YesNoI'm not sureNot Applicable (N/A)

Is this animal spayed/neutered?

YesNoI'm not sureNot Applicable (N/A)

Does this animal get along with dogs?

Yes, this animal gets along with all dogs.This animal does not like dogs.This animal likes some dogs.This animal has not met dogs.Not Applicable (N/A)

Does this animal get along with cats?

Yes, this animal gets along with cats.This animal does not like cats.This animal likes some cats.This animal has not met cats.Not Applicable (N/A)

Does this animal get along with children?

Yes, this animal gets along with children.This animal does not like children.This animal likes some chidlren.This animal has not met children.Not Applicable (N/A)

Is this animal microchipped?

YesNoI'm not sureNot Applicable (N/A)

Please describe this animal's personality.

Is this animal potty-trained?

Yes, this animal is potty-trained to go outside.Yes, this animal is potty-trained to a litter box.Yes, this animal is potty-trained to use potty pads.No, this animal is not potty-trained.Not Applicable (N/A)

Is this animal good on a leash?

Yes, this animal walks great on a leash. No, this animal does not do good on a leash.This animal is okay on a leash, but could benefit from further training. Not Applicable (N/A)

If surrendered, will this animal come with any supplies? Please describe.

Kennel, leash, collar, toys, food/water bowls, etc.

Does this animal have any bad habits? If yes, please describe.

Does this animal have any known health issues/concerns? If yes, please explain.

Is there an adoption contract in place for this animal? Through a breeder, rescue organization, etc. If yes, please explain.

Has this animal bit anyone/anything? If yes, please describe in detail.

Would you be willing and able to foster the dog until the forever home is found?

FYI - Surrender/Foster will not be an option for everyone.

I affirm that all information provided on this questionnaire to KPAL Rescue is true.

I affirm, all the information I provided is true.I do not affirm that all the information I provided is true.

I understand that the beginning and/or completion of this form does not guarantee that KPAL Rescue will take responsibility for this animal.

I understand that KPAL Rescue does not guarantee that they will take ownership of this animal.I do not understand.

Thank you for contacting us. We will be in touch in regards to the animal you're looking to surrender to KPAL Rescue.

Please do not rehome or give your animal away to a potentially unsafe home until we get back with you. We are strictly volunteers, but expect to hear from us within 72 hours of submitting this form.

You can save your current application progress and come back later.

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Surrender/Intake Questionnaire

Your Personal Information

About the Pet

Thank you for contacting us. We will be in touch in regards to the animal you're looking to surrender to KPAL Rescue.