Dog Rescue | Grass Roots Rescue | United States
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animal surrender form

All of our foster homes have other dogs and most have young kids. To ensure their safety, all surrenders must pass our temperament test which includes a dog meet. After receiving the form, we will contact you to schedule the evaluation. If your dog displays signs of aggression towards dogs or humans, we will NOT be able to place them.

Animal #1
Is the animal spayed/neutered?
Is the animal dog-friendly?
Are the animal's shots current?
Is the animal kid-friendly?
Is the animal cat-friendly?
Animal #2
Is the animal spayed/neutered?
Is the animal dog-friendly?
Are the animal's shots current?
Is the animal kid-friendly?
Is the animal cat-friendly?
Animal #3
Is the animal spayed/neutered?
Is the animal dog-friendly?
Are the animal's shots current?
Is the animal cat-friendly?
Is the animal kid-friendly?
Are you able to provide medical records for the animal(s)?
Are you able to make a donation towards the animal's care at this time?

I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the subject of this Animal Surrender Form.

I hereby surrender any and all property rights to the animal. I certify that no other person has a right of property to the animal.

I hereby certify that the animal has/has not (select one) bitten a human or another animal within the past 10 days. 

I understand that once I relinquish the animal, the animal will not be returned to me.

Thanks for submitting!

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