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Owner Surrender Appointment Request Form

We strongly encourage you to attempt to rehome your pet yourself. This can be completed by contacting family, friends and co-workers. If that is not successful, we would recommend that you attempt to find a rescue group to take your pet before bringing it to the shelter. You may view a list of resources on line at If you have considered all options, please complete this form.

Fields marked * are required.

Owner's Name *
Address *
Phone Number *
Email Address *
Pet Name *
Type of Animal *
Age of Animal
Is the animal Spay/Neutered? *
Is the animal up-to-date on vaccinations? *
Why do you want to give up this pet? *
Please be specific.
How long have you owned your pet?
Where did you get the pet from?
Is the animal sick, injured or does it have any known health problems? *
Please describe the pet's temperament. *
Is the pet good with children? *
Is the pet good with dogs? *
Is the pet good with cats? *
Where does the animal stay during the day?
Where does the pet stay at night?
If it is a dog, is it housebroken?
If it is a cat, is it having litterbox problems?
Has the pet ever shown signs of aggression to people or other animals? *
Has the pet bitten anyone in the past 10 days? *


Verification Code Enter the verification code *