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Surrender Application

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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

Dog Information

Dog Name

Dog Age

Dog Gender

MaleFemale

Breed

Is your dog spayed/neutered?

YesNo

Is your dog up to date on annual vaccinations (i.e. DHPP, Rabies, Bordetella)?

YesNo

Has your dog been on monthly heartworm and flea/tick prevention?

YesNo

Where did you originally obtain this dog from?

Have you contacted the original shelter/rescue? If yes, what was their response?

Please explain in detail why you are looking to surrender your pet.

Does your dog have a bite history?

YesNo

If your dog has a bite history, please explain each circumstance.

Does your dog do well around other dogs, cats, kids, strangers?

Better Together Dog Rescue

We receive multiple requests for surrenders. Our ability to assist you depends on space and fosters available in our organization. As a volunteer run organization, we cannot respond to all requests. You will only receive a response from us if we have space available. Thank you for your understanding.

Surrender Fee

I understand that a surrender fee may be involved.

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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