Pack Pride Sanctuary

Name *

Address *

Phone number *

Dogs name *

Dogs age? *

Breed *

If more than 1 dog is being surrendered list additional dogs here Breed: Age: Sex: and Names *

Why are you surrendering your dog? *

Name and phone number of veterinarian *

Short medical history of animal. *

Tell us a bit about the animal. Mark all the apply *

How many hours is your dog alone? Is there anxiety? Do you crate when they are alone or night? Explain all details this helps us adjust the dog to our routine *

Does the dog like car rides? Does car rides make them sick? do they jump in ready to go or are fearful of the car? *

Does the dog walk on a leash? Tell us how does the walking go does the dog pull no training or walk beside you? How does the dog interact with other dogs and people out on a walk? *

Tell us about the dogs daily / weekly activities *

Is the dog stranger friendly? How does the dog react to company in and out of your home *

Feeding routine or schedule and what food/ treats are they food motivated or toy motivated during training ? *

Anything we should know about the Dogs personality. *

Has the animal bit anyone in the last 10 days *

Yes

No

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, hereinafter referred to as “the animal.” 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 understand that by surrendering my property rights to the animal, the animal may be transferred into the custody of an animal shelter. I also hereby certify that the animal has not bitten or scratched a human or another animal within the past 10 days. I understand that once I relinquish the animal, the animal will not be available to be returned. *

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