Surrender Form

Unfortunately, not every adoption is a good fit. We understand that giving up a pet in any circumstance is an emotional decision, and we are here to support you and your family through this choice. To continue, please complete our online surrender form.

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Provide the Pet’s Information

Please complete all required fields as thoroughly and accurately as possible. This information helps us process the surrender and ensure that the animal receives appropriate care.

Submit the Surrender Form

Use the form below to submit the pet’s information. Providing complete details helps our team support the pet safely and compassionately during this transition.

Today's Date(Required)

Name(Required)

First Last

Email(Required)

Phone Number(Required)

Address

Street Address Address Line 2 City State ZIP Code

Patient's Name(Required)

Patient Date of Birth(Required)

Patient Breed(Required)

Medical background information that may be pertinent to the patient's care:

By signing this form, I state that I am the owner of the animal(s) who is the subject of this Animal Surrender Form, hereinafter referred to as “the animal.” To my knowledge, no other person has any rights to this animal. I hereby surrender all rights to the animal. I understand that once I relinquish the animal, it will not be available to be returned. I have read and understand the terms of this Animal Surrender Form.

Signature releasing patient to rescue:(Required)

Surrender Form

Provide the Pet’s Information

Submit the Surrender Form

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