Surrender Request Form

Surrender Request Form

surrender@doghouserescueacademy.org • PO Box 1012 Alva FL 33920
Please keep in mind this is a request form that will be evaluated by a rescue representative. If we have an available foster and funds to take in your pet, we will contact you to complete the surrender process - THIS SURRENDER REQUEST FORM IS NOT A GUARANTEE WE CAN TAKE IN YOUR PET. If you found a lost or stray animal, by law we are not allowed to take it in and it must be processed through Lee County Domestic animal Services (more information here: leegov.com/animalservices/foundpet). If found outside of Lee County, research and contact animal services for the area the animal was found.
Date
Owner Information
Owner Name

First NameLast Name
Owner Mobile Phone Number

Area CodePhone Number
Owner Email
Primary Email
Dog Information
Please write the 1) name, 2) breed(s) 3) age, and 4) sex of the dog(s).
How did you get the dog(s) and how long did you have it for?
Are your dog(s) spayed/neutered?
Do you have proof of vaccines?
Is the dog good with

Other
Owner's Reason for Surrender
List any medication(s) or allergies for the above mentioned pet(s):
List any particular concerns or things the rescue should know about the animal(s) - good and not so good:
Attach any photo(s) you have of the dog

Browse Files

Cancelof
Vet Information
Vet's Name & Address

Veterinarian Name

Street Address

CityState

Zip Code
Vet's Phone Number

Area CodePhone Number
Do we have permission to contact your vet and ask questions about the pet(s) above?
The animal(s) I am doing a Surrender Request Form stated above are my own animals and are not lost/strays I have found
Should be Empty: