Dog Surrender Application

Instructions

Please complete this application as honestly and completely as you can. There are no “right” or “wrong” answers. We will use this information to determine if we are able to help.

* are required fields

Date *

Who Referred You to SWS?

Your Contact Information

Full Name *

Email *

Phone *

Address *

Country

City

State

Zip code

About Your Dog

Name of dog *

Age, sex, breed, approximate weight *

Why does the dog need to be re-homed? *

Where did you get the dog originally? *

Are you the legal owner of the dog? (proof required) *

Yes

No

About ownership

By submitting this application, you attest that you are the legal owner of the dog and have the right to surrender the dog to another party. It is illegal to give away a dog that does not belong to you.

Not legal owner? Please explain. *

Medical Information

Is the dog sterilized (spayed or neutered)? *

Yes

No

Don't Know (explain)

Current rabies vaccination and parvo/distemper vaccine? *

Yes

No

Don't know (explain)

Is your dog on heartworm prevention? *

Yes

No

Don't know (explain)

Does the dog have any health issues? *

Please describe any health issues the dog has, including any dietary requirements.

Behavior

Does the dog get along with other animals? *

Please explain fully

Is the dog housebroken? *

Is the dog destructive when left alone? *

Has the dog ever bitten a human? *

Any other behavior issues? *

Help Us Help You

Are you able to keep the dog in your home until adopted, or find someone who can? *

Will you make a donation to our rescue if we are able to take in your dog? *

Are you willing to make a donation of at least $100 to help keep our rescue afloat? Saving with Soul relies on donations to do our work, and unfortunately, our medical costs far exceed our adoption fees.

What is the deadline for re-homing? *

Anything else you’d like us to know?

Please provide a photo of the dog.

Picture Upload

jpg | jpeg | png | gif format only

Please limit file size to no more than 1MB

You can attach up to 4 images. If you have more than four, you can email them to us at jennifer@savingwithsoul.com. Be sure to include the dog's name

Image greater than 1MB? Resize it: HERE
Standard widths are 800px for landscape and 600px for portrait. Always use "Lock aspect ration."

What happens next?

Saving with Soul Pet Rescue will review your application as soon as reasonably possible. If we determine that we are not able to help, we will let you know right away. If we feel we might be able to help, we will contact you to schedule a time to meet the dog.

Make sure you are human *

For security verification, please enter any random two digit number. For example: 69