Dog Surrender Form

How did you get this dog? *

Why do you want to surrender this dog? *

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? *

Can the dog be trusted alone in the car? *

Can the dog be trusted alone in fenced yard? *

If no to either, please explain *

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? *

We Would Love to Have You Visit Soon!
located 4 miles east of hayward on highway 77 east
10812 N O'Brien Hill Road

Hours

M-Sat 11am - 3pm

Telephone

715-634-5394

Email

paws@northwoodshumanesociety.org

Mailing address

PO BOX 82
Hayward, WI 54843

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The NHS is a nonprofit 501(C)3 organization and receives NO funds from any local, state or federal government. We are a "no-kill" shelter. State of WI Licensed & Inspected, License No. 267329-DS