Request for Rehoming

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

Save Progress

Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

Country

*State/Province

Eligibility

I attest that I live in:

We are currently only providing assistance in the tri-county area.

Orange CountyOsceola CountySeminole County

I am willing to keep ownership of my dog for the minimum of 30 days

We need at least 30 days to help network. It may take longer based on behaviors.

I agree

If my pet is not up to date on vaccines and/or fixed, I understand it is required to provide vetting at my expense prior to adoption

If needed, we can provide resources of low-cost clinics available

I agree

About the pup

Dog's name

Dog's breed

Dog's age

Under 1 year1-4 years5-9 years10 years+

Dog's gender

MaleFemale

Check all behaviors that apply

Please be truthful in your response, as this information is vital to help us properly and safely place your dog

Aggression towards dogsAggression towards people in the homeAggression towards strangersAggression towards kidsSeparation anxiety (destructive when alone, bark/whine when alone)Leash reactivityResource guarding/protective over itemsOther

Please explain the behaviors checked in the question above

The more detail provided helps us learn and understand the dog and the severity of the behaviors.

Is there any medical history we should be aware of?

Provide any other details about personality /temperment

Additional Information

Why you are needing to re-home your dog?

Lack of timeMovingBehavioralMedicalFinancialOther

If other, please explain

How did you hear about our program?

Social MediaWebsite/InternetRescue/shelter referral Referral Other

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.

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

Save Progress