Assistance Request 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

General Information

PLEASE READ: Touch of Grey Rescue considers all owner surrender for altered dogs over the age of 7 years old that reside in the state of Florida. If you are trying to rehome multiple dogs, fill out a separate form for each. If we are unable to intake your dog we will provide additional resources and provide a courtesy post of your dog on our social media for a small donation.

PLEASE READ: We no longer intake senior cats as we are not equipped with cat-specific fosters- we will share a courtesy post for cats over the age of 7 years old that reside in the state of Florida.

Pet's name

Age

Sex

MaleFemale

Spayed/Neutered?

YesNoUnknown

Breed

Approximate weight

How long have you owned your pet?

Was your pet originally adopted from Touch of Grey Rescue?

YesNo

Where did you acquire your pet? Shelter, rescue, breeder, etc.. List name of organizaiton.

Reason for rehoming?

When does your pet need to be rehomed by?

List an exact date.

What happens if you are unable to rehome your pet by the above date?

Are you able to hold onto your dog longer? Surrender to a shelter? Euthansia? Etc.

Please upload a good-quality photo of your pet (no screen shots)

Please upload additional good-quality photo of your pet (no screen shots)

Please upload additional good-quality photo of your pet (no screen shots).

When was the last time your pet was seen by a vet? Please list the name of the vet clinic.

Is your pet up to date on vaccines?

Rabies, DHPP (distemper and parvo)

YesNo

Is your pet on heart worm prevention?

List what medication they take

Does your pet have any medical conditions? Is your pet exhibiting any phyiscal symptoms currently
(related to existing conditions or not)?

Please list any medical conditions your pet has and/or current treatments. If your pet is experiencing symptoms and the condition has not been diagnosed list that too.

Does your pet have any behavioral issues? Example: resource guarding (food, treats and/or toys),
leash aggression, bite history, etc. Please explain.

Please know that this will not affect whether or not we accept your dog/cat into rescue. We only use this information to find them the best fit for a foster home.

Does the dog walk nicely on a leash?

YesNo

Is your pet house-broken? Fully? Partially? No? Please explain.

If your pet utilizes pee pads in the home or needs to be let out X number of hours apart please include this information in your answer.

Do they get along with other dogs, cats, and/or kids? Select all that apply.

DogsCatsChildren under 5 years oldChildren 5 - 12 years oldChildren > 12 years oldNone of the above

Please provide any additional information about your pet that is relevant.

If we are able to offer financial assistance are you interested in keeping your pet?

If you need temporary assistance with covering pet food, prescriptions, minor vet bills, etc.. Please explain below.

Describe your pet’s personality/temperament; lazy, playful, etc.

This helps us advertise your pet better on social media. More descriptive, the better. Do they have a favorite toy, a cute snore, love to walk, etc?

How would you like to be contacted regarding your surrender request? Select all that apply.

Phone callEmailText

If we have an available foster and are able to intake your dog are you willing to make a donation ranging from $50-150 to help offset their care?

The amount will vary depending on the dog’s needs.

If your dog meets the requirements, we will offer a courtesy post on our social media for a small donation. If you would like a courtesy post, please list your preferred contact information: phone number (for calls or texts) or email address, to be included in the post.
Interested parties will contact you directly. Screening potential adopters will be solely your responsibility.

Please include an email address and/or phone number where people can contact you.

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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