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Home
Bark Parks
Beagles!
About
Adoptable Animals
Donate-Membership
Donations
In Honor Of
In Memorial Of
Membership
Other Ways To Give
Volunteer
Thrift Shop
Events & Fundraisers
Community Outreach
Articles & Newsletters
Behavior Issues
Lost & Found
Pet Medical Help
Spay/Neuter
Surrender
Dog Surrender Form
Please complete every box below or the submission will fail to send.
*Indicates Required Field
Dog Surrender Form: Dog's Name
*
Breed
*
Age
*
Choose applicable
*
Male
Female
Choose applicable
*
Spayed
Unspayed
Neutered
Unneutered
Has this dog ever bitten anyone?
*
Yes
No
Did it draw blood
*
Yes
No
Please explain the bite indicent
*
How long have you had this dog?
*
Age when you got this dog
*
How did you get this dog?
*
Stray
Gift
Friend
Pet shop
Shelter/Rescue
Breeder
Abandoned
Why do you want to surrender this dog?
*
Where is this dog used to being kept?
*
Crate
Free roaming
House
Yard
Chained
What have you done to re-home this dog? Why did it not work?
*
Is this dog potty trained?
*
How does this dog let you know it needs to go out?
*
Have you seen any of these behaviors from this dog?
*
Aggression
Startling
Fear of Storms
Growling
Fear of Noise
Begging
Biting
Climbing
Overprotective
Fighting
Animal aggression
Not applicable
Choose any that fit this dog.
*
Jump fences
Tear carpet
Tear furniture
Dump trash
Bark/howl
Chase cars/bikes
Walk well on leash
Ride well in cars
Dig
Chew
Not applicable
Please explain any of the noted behaviors.
*
Can the dog be left alone for long periods of time?
*
Choose any that apply. Does this dog NOT get along with:
*
Children
Women
Men
Cats
Dogs
Other animals
Don't know
Not applicable
Choose any that apply. Does this dog NOT get along with:
*
Not applicable (children)
Not applicable (women)
Not applicable (men)
Not applicable (cats)
Not applicable (dogs)
Not applicable (other animals)
Can the dog be trusted alone in the car?
*
Can the dog be trusted alone in fenced yard?
*
If no to either, please explain
*
Does the dog enjoy car rides? Get carsick?
*
Where does the dog sleep?
*
Is the dog crate-trained?
*
Where is the dog when the family is eating?
*
Where and how often a day is the dog fed?
*
Brand/type and amounts?
*
Has this dog ever been to a vet?
*
If yes, how was he?
*
Are vet records available for this dog?
*
What vet and what name is pet listed under?
*
Contact info for vet, including phone number
*
*
Indicates required field
Please explain anything else we need to know about this dog to find the right home.
*
If this dog is sensitive to being touched, please explain.
*
As owner or agent of the owner of this dog described herein, I do hereby assign ownership of said dog to the Northwoods Humane Society. NHS will become the sole owner of the animal and may care for the animal in any manner the society sees fit. To the best of my knowledge, as owner or agent of the owner this animals HAS NOT BITTEN ANY PERSON, in the last 10 days. Please type your name in the box as electronic authorization.
*
Is this dog possessive of food, toys or people?
*
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone Number
*
Submit