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Surrender

Surrendering a dog can be an incredibly difficult decision. We understand and will take the best care possible of your pet and make sure to find them a new loving home and get them any medical attention they may need. All of our dogs stay in volunteer foster homes before they are evaluated and adopted.Once the fully completed form is submitted, we will be in touch with you as soon as possible.

Your Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Work Phone
Email*
Enter Email Confirm Email
Reasons for surrendering. Please check all that apply.*
- New baby
- Allergic
- Behavior problems
- Moving & can't take dog
- Owner health issues
- Dog health issues
- Can't afford proper care
- Not enough time
- Found/Stray
- Other
If other, please describe
How quickly do you need to surrender this dog?*
- Immediately
- 1 to 2 weeks
- 2 to 3 weeks
- 3 weeks to a month
- More than a month
About the dog you are surrendering
Dog's Name*
Dog's Age & Date of Birth (if known)*
Are you the legal owner of this dog?*
- Yes
- No
Are you the original owner of this dog? If not, please list previous owner (if known)*
Breed*
Please upload a current photo of the dog you are surrendering*
Max. file size: 256 MB.
Is the dog spayed or neutered?*
- Yes
- No
Is the dog male or female?*
- Male
- Female
What color is the dog?*
What is the weight of the dog?*
Where did you get this dog?*
- Breeder
- Rescue/Shelter
- Friend
- Online (Craigslist or other site)
- Pet Store
How long have you had this dog?*
Tell us about this dog. Please check all that apply.*
- Good with other dogs
- Good with cats
- Good with young children
- Would be better in house with older children
- Would be better in a house with no children
- Crate Trained
- Housebroken
- In the process of house breaking
- Walks well on leash
- Friendly and easy going
- High energy
- Has some minor behavioral issues
- Other
If you checked minor behavioral issues or other above, please describe
Does this dog have any behavioral issues. Please select all that apply.*
- Aggression toward other dogs
- Aggression toward cats
- Aggression toward children
- Aggression toward adults
- Separation anxiety / destructive
- Resource guarding (food/toys/people)
- Hyperactive
- No behavioral issues
Please describe in detail any of the behavioral issues you checked above. If there is any history of biting, please describe each incident.*
Does this dog have any health issues? Please select all that apply.*
- Eye issues
- Ear issues
- Breathing issues
- Skin issues
- Heartworm positive
- Lyme positive
- Diabetic
- Seizures
- Mobility issues
- Paralysis
- Blind
- Deaf
- Allergies
- Takes medication
- No health issues
Please list any medications the dog is taking.
What is the dog currently being fed?*
Where does the dog sleep at night?
Is the dog good in the car?*
- Yes
- No
Is there anything else you would like to share about this dog?
Vet's Information
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Date
MM slash DD slash YYYY
Acknowlegement of agreement
I, the above named, agree to the following:*
- I hereby acknowledge that all information submitted in this form is true. I am voluntarily releasing this dog to Wyoming Pug Rescue and give up any right to ownership. I also warrant that I am the sole owner of this dog and have complete legal rights to surrender this dog.
Signature
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Comments
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Adopt
- Adoption Application
- Adoption Fees
Foster
Surrender
Volunteer
Adopted Gallery
Events
My account
- Cart