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

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

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Before you continue...

Before you continue : We are only considering dogs without behavioral issues at this time. Our resources and availability has changed due the impact covid-19 has had on animal rescues. We can only consider dogs who are human friendly, savvy in the home, and HEALTHY with no health issues.

Our current waitlist is very full and we can not give a guarenteed intake date and will give you an estimated intake month that will fluctuate based on how fast our current caseload moves. While waiting on our waitlist you must check in with us for updates on when a spot is availible.

Please fill out the questions below with your dogs information. Once we review your form, if your dog meets our intake criteria we will request vet records for your dog showing they are up to date on rabies and distemper\parvo vaccines, spayed\neutered, and heart worm negative. We require a heartworm test compelted within the last 30 days because of the nature of heartworm and how it can develop over time.

*For all out of state dogs we require a CVI (Aphis-700 certificate of vertrinary inspection). You can read about this on our website https://www.secondchanceranchrescue.com/intake

Your dogs information

Your dogs name

Age

Breed(s), color, and size

Where did you originally get your dog from? (breeder, rescue, other) and how long have you had the dog?

Did you contact the breeder or rescue for help? Often times breeders and rescue's have contracts that require you return the dog to them.

YesNo

Why do you want to surrender your dog? What have you done to try to keep your dog? (training etc.) Is there any way we can help you keep your dog?

Your dogs behavior

Is your dog good with other dogs? Please select all that apply

YES, VERY SOCIAL AND PLAYS WITH OTHER DOGS OFTENYES, SOMEWHAT SOCIAL AND SOCIALIZES SOMETIMESYES, SOCIALIZES WITH MY OTHER DOGS IN THE HOMESORT OF SOCIAL, STRUGGLES OR IS PICKY WITH THEIR FRIENDSNO, NOT SOCIAL AND IS VERY REACTIVE AND STRUGGLES WITH SOCIALIZING WITH DOGSNO, IS DOG AGGRESSIVE AND HAS BEEN IN FIGHTS WITH OTHER DOGS BEFORE.

Describe your dog with people. Do you have people over your home often? How does your dog do? Do you go out in public - how does your dog do with people in public. Be as detailed as possible

We will confirm all of this in person when we assess your dog

Has your dog ever met cats? How does your dog do with cats?

Has your dog ever met kids? How does your dog do with kids?

Is your dog crate trained? When are they crated? Does your dog have any issues with being left alone? Any separation anxiety or destruction when alone?

Describe your dogs overall training (leash training, commands, manners, relationship with you, activities they do, overall behavior)

Do you use a shock or bark collar on your dog? If so when and why?

Has your dog ever bitten a human? When? Please describe the situation and be as detailed as possible

Has your dog ever bitten a dog? When? Please describe the situation and be as detailed as possible

Your dogs health

Is your dog spayed\neutered?

YesNo

Is your dog up to date on vaccines (rabies, distemper\parvo)

We require vet records prior to intake to confirm this

YesNo

Does your dog have any health issues, allergies, or on going medical needs?

Is your dog heartworm negative? Have they recently been tested within past year? Has your dog been on heartworm preventative? Depending on your dogs background we will require a heartworm test from within past 30 days.

Agreements

Do you agree that your dog has not bitten a human or dog within the last 30 days?

YesNo

Do you agree to pay the $150 surrender fee and bring all of your dogs belongings to the ranch?

YesNo

If you are out of state do you agree to obtain a CVI and send it to us to review by email?

YesNo

Agreement to surrender and give up all rights to the dog

Do you agree to surrendering all rights to the dog? By filling out this form and electing to surrender the dog you are agreeing to the following terms:
1. We will not intentionally disclose any of your personal information to adopters or to anyone outside of our rescue.
2. You must provide all vet records to us to prove the dog is up to date and healthy or to show existing medical or behavioral issues. We can not guarantee that personal information from vet records will not be transferred to adopters.
3. Adopters are not disclosed to anyone outside of our team. You agree not to contact the family \ adopter who adopts your dog.
4. All updates given to the public and past owners are at the discretion of the team. We can not commit to updates.
5. You will not be included in future decisions for your dog once you surrender or be allowed to weigh in to determine the dog's next family\ adopter
6. You are giving up all rights to the dog and ZERO RIGHTS to the dog after surrender

I agree to surrender the dog and to all terms outlined above.

YesNo

Digital Signature

By filling in the digital signature you are providing a digital signature and agree that:

You are giving up all rights to the dog and once you drop off the dog\ surrender the dog to The Ranch you can not reclaim the dog and have ZERO RIGHTS to the dog.
All of the information provided in the form is truthful and accurate
You have not with held any information such as past bites or dog fights have been left out
You understand that The Ranch is not responsible for providing any updates to you
You understand that The Ranch can not guarantee your information is private from next family (due to vet records that will be exchanged) but trust that The Ranch makes their best effort to keep your information private.
You will be cordial , polite, and courteous to The Ranch in all discussions and email exchanges.

Digital Signature

By filling in the digital signature you are providing a digital signature and agree that: You are giving up all rights to the dog and once you drop off the dog\ surrender the dog to The Ranch you can not reclaim the dog and have ZERO RIGHTS to the dog. All of the information provided in the form is truthful and accurate You have not with held any information such as past bites or dog fights have been left out You understand that The Ranch is not responsible for providing any updates to you You understand that The Ranch can not guarantee your information is private from next family (due to vet records that will be exchanged) but trust that The Ranch makes their best effort to keep your information private. You will be cordial , polite, and courteous to The Ranch in all discussions and email exchanges.

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

Owner Surrender Form

Personal Information

Before you continue...

Your dogs information

Your dogs behavior

Your dogs health

Agreements

Agreement to surrender and give up all rights to the dog

Digital Signature