Owner Surrender Questionnaire

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Personal Information

Dog Information

Please be as truthful as possible. This will help us to find the best foster home possible.  We will work with you to determine if we can accept your dog into our rescue program, as well as determine a timeframe.

Please describe interest and reaction. Is the dog hyper and nervous? Or lay down and relax? Is there a history of getting car sick? How often does the dog ride in the car? UNKNOWN is an acceptable answer. Thank you for sharing as much as you can.
Example: Home Depot, Tractor Supply, Dog Park
Example: Sit, Stay, Come, Here, Leave it, etc.
Please include how much and how many times per day

Medical Information

Include heartworm, flea & tick preventative, supplements, insulin, etc.
Example: Doesn't like nails trimmed, doesn't like to ride in the car, separation anxiety, is scared of thunderstorms, etc.
Please include City, State, and Zip Code

Additional Information

Our foster program relies on volunteers. We do our best to act as quickly as possible, but it can take several days (sometimes longer) to find a foster home. Sometimes, transport will need to be arranged. We need to know how urgent your need is for help and what timeframe we have to work within.
Each "question" will allow you to upload one file or photos. You may also email photos to info@oesr.org if you have any trouble uploading directly to this form. Thank you,

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