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

Surrendering My Pet for Adoption

Please give as as much detail on your pet so we can place your pet in the best home possible. We are a no-kill Animal Rescue and your pet will not be euthanized.

What type of surrender?

Transfer from an Animal Advocate OrganizationOwner has passed away and I have authority to surrenderReturned AdoptionOwner ReleaseOther

Why are you having to Re-home/Transfer your pet(s)?

Number of animals surrendered

Pet(s) name

Species of animal(s) are your surrendering?

Dog CatOther

Male/Female

Male Female

Is your pet spayed or neutered

YesNoI am unsure

Date of Birth if known if not please put estimated age

Breed of your pet(s)

Color or pattern of your pet (s)

MicroChip Information (Click all that apply)

Not ScannedScanned - No ChipScanned - ChipDo not know if there is a chipHas a Chip in name of owner surrendering - Will need to be transferred

Microchip #. (Please indicate the chip company if known)

First Picture of your pet

Second Picture of your pet

Third Picture of your pet

Please complete Bio of your pet. This helps find the right home.

Select all that apply

Does not like kidsGreat with KidsPrefers older kidsLikes CatsDoes not like CatsDog friendlyIs dog selectiveOnly gets along with opposite sexHouse trainedNeeds to be cratedDoes not need to be cratedHas been trained to walk on leashNeeds to learn to walk on leashPulls when walkingLikes to cuddleSleeps in my bedSleeps in a crateOutside dogDoes not like to be picked upIndoor CatOutdoor catHouse trained

Is your pet up to date on all vaccines?

YesNo

If you had your pet since a puppy did they receive 3 set of puppy vaccines?

This helps us place your pet in a safe foster home. Please list how many sets you know your pet has had and include dates if known.

Has your pet had a Heart Worm test in the past year?

Please indicate the date of test if known.

Has your pet been on prevention like Heart Worm or Flea prevention?

Has been regularly on Both Hw and flea preventionHas been regularly only on Hw preventionHas been regularly only on flea preventionHas received sporadic preventionsHas never received preventionsOther

Please indicate the last date that your pet had preventatives, if known.

Ex: HW Preventative (Iverhart) given on 7/15/2024; Flea Preventative (Frontline) given on 7/15/2024.

Please provide any known medical history. Please include any medical notes so that we can help your pet moving forward. Example: Due for vaccines, etc.

If your pet is due for any vaccines or tests are you able to pay for these?

YesNo

By signing this document you agree that all information provided in this document is true to the best of your knowledge. You understand that you are surrendering your pet to Mutts N Such Rescue. If you have surrendered your pet then you have given up all rights to your pet to Mutts N Such Rescue. We do promise to place your pet in a new home that has passed our qualifications.

I agreeI do not agree

Upload picture of valid driver's license

Please type full legal name. *Must match drivers license.

Digital Signature

Please upload any medical records that you are willing to share.

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. Please note that some organizations have higher age requirements and may require applicants to be 18 or 21 years of age or older. Be sure to review the specific instructions and eligibility requirements for each application carefully before applying.

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

Save Progress

Mutts N Such Owner Surrender Form

Personal Information

Surrendering My Pet for Adoption