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

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

Country

*State/Province

Surrendered Pet(s) Profile

You may use this DogSurrender Form for a litter of puppies. Feel free to use the notes section at the bottom for any additional info you may want to include

Are these pet(s) stray(s) with no microchip?

Did you find these pet(s) on the street or in a yard and have checked to see if they are microchipped?

YesNo

Breed

Age

Sex

female spayedmale neuteredfemale male

Reason for Surrender

Bite History?

YesNo

Name(s) of Pet(s)

If pets are a litter that is unnamed you may enter N/A

Where did you get your pet(s) from?

How long have you had your pet(s)

Notes

Additional info you may want to add

Pet Description

Please answer as complete and thorough as possible. This helps with their pet profile and is the easiest way to get them adopted asap. Include as many details as you can.

Pet(s) are described as:

Check all that apply (multiple choice)

Family Friendly Pet(s)One Person HouseholdOnly Pet HouseholdDog FriendlyFor Adults OnlyCat Friendly

Frequency of inappropriate eliminations?

Does your pet pee/poop in wrong places?

neversometimesoftenalwaysspecial needs

Is your pet(s) mostly

indoor/outdoor

indoor onlyindoor & outdooroutdoor roaming only

Potty Trained?

YesNo

Leash Trained?

YesNo

Notes

Pet(s) Daily Routine

Please answer as complete and thorough as possible. This helps with their pet profile and is the easiest way to get them adopted asap. Include as many details as you can.

How many hours is your pet(s) left alone in a day?

Pet(s) live with:

what do they live with? check all that apply

SeniorsAdultsTeenagersToddlers/BabiesDogsCatsExotic AnimalsFarm Animals

What things are your pet(s) afraid of?

Where is your pet(s) kept throughout the day?

outside free roamindoorcrateoutdoor enclosed areafree range with doggie door

When left alone your pet(s)

CryWhineScratchHowlChewsTries to escapeinappropriate elimination

Describe daily routine

What food does your pet(s) eat?

Please list name and brand.

How often do you feed your pet(s)

Does your pet(s) have favorite toy?

If yes please explain

Favorite spots to nap/sleep

What makes them happy/excited/relaxed?

what type of eaters are they?

Picky, Delicate, Voracious, etc

Describe their personalities:

Commands known

SitStayComeKnows NameFetchDownHeelOk/ReleaseshakeWalk/OutsideKennel/Crateadditional commands not notednone

What does your pet dislike?

Notes

Pets Health History

Overall Health

Any special needs?

if Yes please explain

Is your pet(s) on any medications?

If yes please list

Does your Pet(s) take monthly Flea/Tick Prevention?

If yes please name which type

Does your Pets(s) take monthly Heartworm medication?

If Yes please name which type

Medical records upload

Medical Records Upload

Vaccine History

Any Major Surgeries or hospital stays?

If Yes please explain

Food brand/type

Photos

Please create a share album of photos/videos of your pet and share it with email: HDBNQRESCUE@GMAIL.COM

YesNo

notes

By Agreeing (YES) and Submitting this form you agree to the following:

• The above information reflects the animal(s) in which I am surrendering to Hella Dam Bitches n Queens Rescue. • I am the owner of this animal and have full right to surrender • I understand that I cannot ask for this animal back after this form is submitted to Hella Dam Bitches n Queens Rescue • This animal was not from a Rescue other than Hella Dam Bitches n Queens Rescue. • This animal is now under the complete ownership of Hella Dam Bitches n Queens Rescue. • My submission of this form reflects that I have read and understand the information provided above and I am hereby releasing all rights for this animal to Hella Dam Bitches n Queens Rescue.

YesNo

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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Dog Owner Surrender Form

Personal Information

Surrendered Pet(s) Profile

Pet Description

Pet(s) Daily Routine

Pets Health History