Shelter From The Storm

Owner Relinquishment

Last Name:

First Name:

Street Address

City:

State

Zip:

County:

Phone No:

Email:

Animal's name:

Why are you looking to surrender this animal?

Has this animal ever bitten?

If yes or unsure, please explain:

How long have you had this animal?

Where did you get this animal?

Have you also contacted other organizations about taking in this animal?

If yes to previous question, what has their response been?

Description of animal:

Dog or Cat?

Dog

Cat

What breed or breeds is your animal?

Age?

Spayed or Neutered?

Yes

No

Unsure

Current on vaccinations?

Yes

No

Unsure

If a dog, has it been kept on Heartworm preventative?

Yes

No

Unsure

If a cat, is it declawed?

Yes

No

Unsure

What kind of food do you feed your animal?

Is there any medical problems this animal has now or has previously had that a new owner should be aware of?

Name and phone number of your Vet:

Where does the animal spend most of it's time?

How soon do you need to rehome this animal?

How does this animal react to the following:

Other animals:

Strangers:

Men:

Women:

Children:

Petting:

Taking away food:

Taking away treats:

Taking away toys:

Is there specific places your animal does not like to be handled, such as feet or tail?

Does your animal seem afraid of storms?

Has this animal ever been destructive to your property?

Yes

No

If yes, please explain:

Please list any behaviors that your animal needs improvement on:

Which of the following terms would you use to describe your pet?

What are your pets favorite things to do, favorite treats and toys? Does it know any commands?

Please provide any further information that you feel would be helpful for your application.

We ask for a $50 surrender donation to help towards caring for your pet if we agree to accept it into SFTS

By signing below with my initials, I certify that all the above information is true to the best of my knowledge and I recognize that any misrepresentation may result in the loss of my animal being accepted into rescue. I understand that the veterinarian I listed may be contacted. I also understand that Shelter From The Storm will contact me after processing the application, which can take time. Enter your initials here. This qualifies as your signature.

Inside house	Outside in a kennel	In a barn	In a garage	Tied up outside
Outside loose	In a fenced yard	Other

Friendly	Shy	Scared	Aggressive	Worried	Affectionate	Outgoing
Cautious	Protective	Difficult	Stubborn	Obedient	Lazy	Hyper
Easy going	Calm	Quiet	Fearful	Dominant	Smart

Shelter From The Storm Owner Relinquishment

Description of animal:

How does this animal react to the following:

Shelter From The Storm

Owner Relinquishment