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Surrender Form

Home » Surrender » Surrender Form

As Beagle lovers and advocates, we do try to help people who need assistance with their dogs. We are contacted to provide assistance daily and because of the number of requests, limited space, and lack of funds, we first ask that we assist you with whatever issues you are encountering. We strongly believe that pet ownership is a lifetime commitment and expect a pet owner to try every viable option prior to requesting to surrender their dog.

Also, please remember–while we wish we could help every dog with every issue, every time, we are not always able to. We are an all-volunteer non-profit with very limited resources. If we are not able to take your Beagle, we can refer you to other rescue groups or no-kill shelters.

Please be sure to read this page first before completing this form. Thank you.

"*" indicates required fields

Name*

First Last

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Phone number*

Phone number type*

Cell

Home

Work

Other

Pet(s) Information

Please fill this section out for all pets you are requesting to surrender.

Dog's Name(s)*

Age(s)*

Breed/Breeds*

Breed Type*

If surrendering more than one pet, please select all appropriate types.

Purebred

Mixed

Unknown

Gender*

If surrendering more than one pet, please select all appropriate types.

Male

Female

Spayed/Neutered?*

If surrendering more than one pet, please select all appropriate types.

Yes

Are you willing to get your pet spayed/neutered prior to surrender?*

Yes

Where did you acquire this dog?*

Rescue

Breeder

Shelter

Individual

Other

From which rescue group did you acquire your dog?*

What is the name of the breeder from which you acquired the dog?*

From which shelter did you acquire the dog?*

From whom did you acquire the dog?*

Please explain where you acquired this dog.*

Up to date on vaccines?*

Yes

Date of last vaccines*

Are you willing to get your dog's vaccines updated prior to surrender?*

Yes

Is the dog microchipped?*

Yes

Company with whom microchip is registered*

Microchip Number*

Up to date on heartworm prevention?*

Yes

Date of last heartworm test*

When was last dose of heartworm prevention given?*

What brand of heartworm prevention is the dog on?*

Are you willing to get your dog heartworm tested and started on prevention prior to surrender?*

Yes

Name of veterinary clinic*

Veterinary clinic number*

Does your dog have any behavioral concerns? (List any current as well as past behavioral issues.)*

Does your dog have any health concerns? (List any current as well as past medical conditions)*

Friendly with (mark all that apply)*

Men

Women

Children

None of the above

Friendly with (mark all that apply)*

Dogs

Cats

Neither

Please list the age(s) and size(s) of dogs the dog has been around.*

Please give a detailed description of the reason(s) you have asked us to re-home your dog.*

Please list the age or age range of children the dog has been around.*

What have you done to try to overcome the issues you are having?*

Please write a bio for your dog. Imagine an online dating profile for canines. 🙂 Include likes, dislikes, personality, etc.*

Are there any situations your dog does not do well with? (i.e. Dog Park, Veterinarian, with large/small dogs, with men in hats, etc.*

Yes

Please list any situation in which your dog does not do well as well as what their reaction is.*

Are you able to keep your dog(s) until we are able to find a foster or forever home for them?*

Yes

Is there a date your pet must be re-homed by?*

Are you able to make a donation to our organization to help with the costs of vetting, housing, feeding, etc? (Donations are tax-deductible.)*

Yes

It's important that you please call and authorize your vet's office to release your pet's medical records to us. Thank you.

Please let us know you're human

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