OWNER SURRENDER FORM

Your full name

Your email address

Confirm email address

Your daytime phone number

Your evening phone number

Your full address

Your postcode (essential)

Your dogs name

Your dogs age

Your dogs breed

How long have you had this dog?

Reason for rehoming.

Timescale for rehoming

Where did you get your dog from?
Adopted from a rescuePrivately rehomedPurchased from a breederInherited from familyI am the breederOther

Is your dog friendly towards adults and children?

Is your dog friendly towards other dogs? How would you describe their interaction?

Is your dog okay with cats?
YesNoNot sure

Is your dog okay to be left alone? If so, for how long?

Is your dog neutered?
YesNo

When was your last dog vaccinated?

When did you dog last go to the vets?

Current and/or previous vets name and address

Does your dog have any health issues? Please include everything, regardless of how minor they may seem.

Does your dog have any behavioural issues? If so, please describe these and include how they present and what the triggers are.

Please tell us as much as possible about the dogs general character, and any other information you think might be useful. It is helpful if you include as much detail as possible here - it is not possible for us to assess whether we can help with limited information.