Surrender a Dog

Owner Information

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Name

First Last

Breed

Sex (spayed or neutered status)

Age

How long have you had your pet?

Bite history (attempted bites included)

Lived with (cats/dogs/kids) any issues with any of those?

Where did you get pet from?

Where is pet when alone, any issues?

Is dog housebroken?

Has your dog gone through any training, if so, who did you use?

What are the best things about your pet?

What are the things your pet struggles with?

Why are you wanting to surrender?

What kind of timeline are you looking at to surrender?

Any other information that would help the staff at HSSEMO?

Brand of pet food given?