Owner Surrender — Thomasville Humane

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Owner Surrender

Complete this application to initiate the request to surrender legal of ownership of your animal(s) to Thomasville Humane. After submission, we will schedule an Owner Surrender Appointment. If your request is approved, you will pay the prescribed fee (which is determined on a case-by-case basis) and surrender your animal(s) to Thomasville Humane.

Owner Name *

First Name

Last Name

Email *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Pet Name *

Pet Type *

Litter? *

Are you seeking to surrender a litter of puppies or kittens?

Yes

No

Breed *

Age - Years and Months *

Pet Birthday

If known.

MM

DD

YYYY

Sex *

*

Microchipped? *

Yes - Provide chip info below.

No

Microchip information

Why are you surrendering your pet? *

Please give any behavioral issues.

Please check all appropriate choices. *

Pet has bitten a person.

Pet has bitten another animal.

Pet has never bitten a person or another animal.

Pet is good with dogs.

Pet is good with cats.

Pet is good with children.

Where is the pet kept? *

What is the pet's overall attitude and demeanor? *

Check all behaviors that your pet exhibits. *

Urinates/Defecates Indoors (not litter box)

Fights with other animals

Chases cats

Car sickness

Chews on furniture

Jumps on people

Bites or Scratches

Veterinary Clinic/Office *

Veterinarian Name *

Is your pet current on all vaccinations? *

Yes

No

When are vaccinations due again? *

Is your pet on flea, tick, and heartworm preventative? *

Yes - Please provide type below.

No

Preventative type

Does your pet have any medical issues or concerns? *

Yes - Please describe below.

No

Medical concerns

How long have you had your pet? *

Other comments:

Your owner surrender application has been initiated. We will contact you to schedule your owner surrender interview. Thank you.

Thomasville Humane

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