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Owner Surrender Request

Fur-Get Me Not Animal Rescue, Inc. has it's own process when it comes to surrendering your dog. Please follow the below steps:

Fill out our Owner Surrender Form, with as many details as possible, as accurately as possible.
A representative of Fur-Get Me Not Animal Rescue, Inc. will reach out to you to discuss your surrender, as well as a possible date/time to meet up with you and your dog. At that meeting, our representative will do his/her best to temperament test your dog following our guidelines.
If we take the dog, you MUST sign the Owner Surrender Agreement and immediately surrender your dog.

Please Note:

By submitting the below Owner Surrender Form, this does not guarantee that Fur-Get Me Not Animal Rescue, Inc. will take your dog. There are many factors that determine whether we can and/or will take your dog. Some of these factors are, but not limited to, Temperament, our capacity, the availability of a foster.

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
-

Email*

Home Phone*

Work Phone
x

Cell Phone

Text/Pager Email*

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Dog Details

What is the name of the animal you want to surrender to us?*

What breed is your dog? Be specific, even if the dog is a mixed breed.*

Is your dog up to date on Rabies vaccination?*

Is your dog up to date on DHLPP vaccination?*

Is your dog up to date on Bordatella vaccination?*

Does your dog receive Heartworm preventative?*

Does your dog receive flea and tick control?*

Your Veterinarian's name:

Your Veterinarian's Phone Number:

Is your dog Spayed or Neutered?*

Please provide the DOB of your dog. If you are unable to, or do not know the exact DOB, please provide their age.*

Please provide your dog's weight.*

Where did you get your dog, i.e., did you purchase from a breeder, adopt from a Humane Society, etc.*

How long have you had your dog?*

Is your dog good with (please select all that apply):

Large Dogs	Small Dogs
Male Dogs Only	Female Dogs Only
Young Kids (Ages 10 and Under)	Older Kids (Ages 10 and Over)
Cats	Livestock (Chickens, Cows, etc.)
Men Only	Women Only
Needs to be an only dog	I Don't Know

Has your dog bitten, injured or maimed another person? Please be as descriptive as possible, describing the circumstances:*

Has your dog bitten, injured or maimed another animal? If so, please describe in full details below:*

Does your dog have any injuries or illnesses? If so, please be as descriptive as possible below:*

Please describe your dog's personality traits, selecting all that apply:

Crate Trained	House Trained
Indoor Dog	Outdoor Dog
Chewer	Destructive
Friendly	Playful
Shy/Timid	Calm
Aggressive	Protective
Energetic	Leash Trained
Some Obedience	No Obedience

Why are you surrendering your dog?*

Is there anything else that we should know about your dog, i.e., behavior, medically, etc.? If so, please provide details below:

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Terms and Conditions

I have read and answered each question on this Owner Surrender Form, truthfully, to the best of my ability. Furthermore, I am providing consent to Fur-Get Me Not Animal Rescue, Inc. to contact my Veterinarian for further information if needed (Please contact your veterinarian immediately asking to release your dog's medical information to us). Agreeing and Submitting this form is providing a signature.

Do you agree to the above terms?*

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