ANIMAL SURRENDER FORM

Animal surrender profile forms and veterinary records are critical to our assessment process. The more we know about your pet, the better we’re able to place him or her into a new home. If your address is not completely filled out your submission form will be denied and you will have to submit another form.

The cost to care for and to re-home pets can be in the hundreds of dollars for each animal that comes into our care. Eddy’s Dogs aka Eddy’s K9 Rescue asks for a suggested minimum $50 donation at the time of surrender.

Eddy’s Dogs is a local, independent 501(c)3 organization that is funded solely by donations. Eddy’s Dogs receives no funding from the government or tax revenue.

Please answer the following questions:

Owner's Name *

First

Last

Phone:

Address:

Apt:

City:

State:

Zip:

Email *

Animals Name:

Age:

Breed:

Color:

Neutered/Spayed:

Date of last vaccines:

Medical Issues/Allergies:

Vet Name:

Phone:

Can you get medical records:

Medications:

Microchip #:

Company:

Reason for surrender:

How would you describe your dog's temperament:

Good with dogs:

Good with Cats:

Good with Kids:

Likes:

Dislikes:

Housetrained:

Food Aggressive:

Crate Trained:

How does your animal react when you pet them or approach them while they are eating food, playing with a toy, or chewing on a treat?

How does your animal react while on a walk and another dog/cat is nearby?

How does your animal react while on a walk and another person or group of people walk by?

Agressive:

Bitten/Scratched Human:

Bitten/Scratched Animal:

Any additional comments?

By signing I hereby acknowledge that I am the lawful owner of the animal I am seeking to surrender and I came into possession of this animal legally. I hereby certify that I am the rightful owner of the animal who is the subject of this Animal Surrender Form. I hereby surrender any and all property rights to the animal. I certify that no other person has a right of property to the animal. I also hereby certify that the animal has not bitten or scratched a human or another animal. I understand that once I relinquish the animal, the animal will not be available to be returned. I further certify that I have read and understand the terms of this Animal Surrender Form. Owner's Name and Date: