Dog Surrender Form

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Personal Information

Dog's Information

Signature

My signature below certifies that I am the owner of, or have the authority to surrender to Nerdy Paws Animal Rescue, the animal described above. I hereby relinquish all rights of ownership and any right to information on the disposition of said animal.  I also authorize the release of any veterinary records regarding the animal. I certify that to the best of my knowledge I have disclosed all information about the animal concerning health, behavior, history and anything else that may affect the safe placement of the animal in a new home, and that all statements made above are true and correct.



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