Owner Surrender

Name

First

Last

Full Address

Numbers

Email

Reason for surrender?

Please answer the following questions to the best of your ability. There is no right or wrong answer. This form simply helps us understand your pet and best match them with a foster or adopter that fits their needs. This also helps us anticipate any future expenses or training required. A copy of each pet’s vet records must accompany this request form. We will not review any requests unless this is provided. If your animal has never been vetted, make a note on the form below. AH Rescue Sanctuary requests a $50 donation for each pet that is surrendered. If you cannot make this donation, please make a note here and the reason why this donation cannot be made. Please note that by submitting a request for an owner surrender does not guarantee that we can take your pet. If we are able to assist and take your pet on, we require a donation to be made on that pet’s behalf at that time.

Number of pets requesting to surrender:

Selected Value: 1

How soon do you need your PET(S) placed?

Owner Surrender fee/donation:

$50/pet
$50/month

$50/per month helps cover the costs of food and routine care.

Have you taken any steps to try and correct the behavior or reason for surrender? If yes, list what steps you have taken.

Pet 1

Must Include Age, Gender, Breed, Fixed, Vaccinations, Health Issues, date last saw the Vet. (Examples: Diabetes, heartworm positive, pregnant…) **Please note, a health issue does not disqualify an animal to be surrendered to AHS, it simply helps us know what expenses to expect in the future. Please be completely honest with us.

Check Those that Apply

Pet 2

Check Those that Apply

Pet 3

Check Those that Apply

Pet 4+ any others

Check Those that Apply

Have any of the pets you wish to surrender shown any kind of aggressive behavior? If yes, list the pet and explain what you have experienced.

Do any pets have a bite history? If yes, list the pet and the incident(s) that took place.

Have your pet(s) completed any sort of training? List what that training was and provide a copy of the complete training certificate by email.

Additional notes regarding my pet(s):

(Please list any additional notes you feel we need to know regarding your pet)

Type Full Name to Agree to this Form

First

Last

I agree that I have completed this form to the best of my knowledge and have provided AH Rescue Sanctuary with the complete history of the pet(s) I wish to surrender. I also understand that it is not guaranteed that AH Rescue Sanctuary can take my pet(s) I wish to surrender. I also understand there is a required surrender fee/donation to help with maintenance/care expense of my surrendered pet(s).

Owner Surrender

May take 1-3 weeks to process applications before you are notified.

May take 1-3 weeks to process applications before you are notified.

Please send your Donation through one of these options with your name and the name of the animal. Thank you.