Dog Surrender Form

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Please Read

The first step in surrendering your pet, is to fill out this form. Submitting this form does not guarantee that we will be able to take your pet. Acceptance into our dog/puppy program is dependent upon whether or not we have appropriate foster care for that animal’s needs and whether or not we have the resources necessary to ensure their health. Our dog/puppy program is very small, but we are working on expanding it to help as many dogs and puppies and we can.

If you have multiple animals, please submit a separate form for each animal.

AOH staff will review the information and determine whether or not your dog is a good fit for our program.

Please note: Angel of Hope does not have the ability to take in animals with a significant bite history.

Please request your veterinary hospital to email your pet’s records to questions@aohrescue.org.

If your dog is accepted, we will set up a date/time for you to bring them to our office in Dayton. When you arrive for your surrender appointment, AOH staff will observe your animal’s behavior. If staff cannot safely handle your animal, we will decline to accept your pet into our program and will suggest alternative options.

About Your Dog

How did you hear about us?

Online SearchPetfinderFacebookFriend / FamilyOther

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Pet's Name

*

What breed/size is the dog? Estimated weight?

*

Age of the Dog?

*

Gender?

MaleFemale

*

Are they spayed or neutered?

YesNo

*

What is your reason for surrender?

*

Is your pet up to date with Vaccinations?
Date of last vet visit?

*

Are there any health issues that we should be aware of?

Special medial needs, medications or special foods they are on?

*

Did you get this pet from Angel of Hope originally?

If so, when?

*

If not from AOH, where did you get the pet from?

How long have you had the pet?

*

Are there any behavior issues we should be aware of? Disclosing behavioral concerns does not exclude acceptance but will help find appropriate placement.

Fear, anxiety, destructive in a home, aggression issues?

*

How is the dog with
other dogs?
Cats?
Kids?

Please answer for all categories.

*

Has the dog ever bitten before?

If yes, please explain the circumstances of what happened.

*

Is the dog potty trained?

YesNo

*

Is the dog crate trained?

YesNo

*

Has the dog been primarily kept indoors or outdoors?

IndoorsOutdoors

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What vet have you been taking your pet to for wellness?

Name and Phone number.

*

Do you give permission for your Vet to release this pets records to Angel of Hope?

YesNo

*

Photos

Please attach a current photograph of your dog.

Please upload a copy of your dog's most recent rabies certificate.

Please upload a copy of your pet's medical records.

What type of food are you currently feeding your dog?

Is your dog currently on any medications or supplements?

Such as heartworm, Flea/tick, fish oil, medications you got from your vet.

By completing and submitting this form:

*

I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the subject of this Animal Surrender Form, herein after referred to as “the animal.”

I agree

*

I hereby surrender any and all property rights to the animal.

I Agree

*

I certify that no other person has a right of property to the animal

I Agree

*

I also hereby certify that the animal has not bitten or scratched a human or another animal within the past 10 days.

I Agree

*

I understand that by surrendering my property rights to the animal, the animal will become property of Angel of Hope Animal Rescue and will not be returned to me.

I Agree

*

I have disclosed any behavioral and health issues for the listed animals.

I Agree

*

I further certify that I have read and understand the terms of this Animal Surrender Form.

I Agree

*

I agree my electronic signature is the legal equivalent of my manual signature on this Application. By selecting "I Agree" I consent to be legally bound by this Application's terms and conditions.

I Agree

*

By typing your name, you are providing your electronic signature to this application

I have read and agree to the terms and conditions. By checking this box I am confirming that I am 13 years of age or older.

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