Owner Surrender Appointment Request Form
If you have exhausted all other options and would like to make an appointment to surrender your pet, please fill out this form in its entirety.
Owner Name(*)
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Address Line 1(*)
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Address Line 2
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City(*)
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State(*)
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Zip Code(*)
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Phone Number(*)
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Email Address(*)
Please enter a valid email address
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Pet Name(*)
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Type of Animal(*)

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Breed or Mix?(*)
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Age of Animal
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Is the animal spayed or neutered (i.e. fixed)?(*)
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Is the animal up-to-date on shots?(*)
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Why do you want to give up this pet (please describe in detail)?(*)
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How long have you had the pet?
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Where did you get the pet from originally?
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Is the animal sick, injured or does it have any health problems?
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If yes, please describe the health problem
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Please describe the pet’s temperament:


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Is the pet good with children?
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Is the pet good with dogs?
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Is the pet good with cats?
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Where does the animal stay during the day?
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Where does the pet stay at night?
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If it is a dog, is it housebroken?
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If it is a cat, is it having litterbox problems?
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Has the pet ever shown signs of aggression to people?
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If yes, please explain circumstances:
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Has the pet bitten anyone within the past 10 days?
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If you have a digital picture of your pet and can send it to us, please upload it here
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Submit