Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Name of pet(s) being surrendered:
Owner's Name(s):
*
Breed/Description
Birth Date
MM
DD
YYYY
Sex and Spay/Neuter Status
How did you get this pet?
Is this pet microchipped? If so, provide brand and microchip number:
Including yours, how many homes has this pet had?
How long have you had this pet?
Other household pets (indoor and outdoor)
Would you recommend placing this pet in a home with dogs?
If no, please explain _____________________________________________
Would you recommend placing this pet in a home with cats?
If no, please explain _____________________________________________
Are there any species you would NOT recommend placing this pet in a home with? If so, explain.
Explain how this pet was confined to your property:
Has this pet ever escaped confinement?
Is this pet housebroke?
Is the pet permitted to sit/sleep on furniture?
Is this pet crate trained?
When left alone, is the pet
Is this pet destructive if left alone in the house?
Is this pet protective or possessive toward any of the following
Livestock Only: Does this pet:
Has this pet ever bitten another pet?
Has this pet ever bitten a human?
Behavior
Check all that apply
Describe this pet's play style:
Does this pet have any experience with children?
Would you recommend this pet to live in a home with children?
Does this pet receive routine veterinary care? List the veterinary clinic name and phone number:
You can also have your clinic email records to rescue@soniassanctuary.org
Health History:
Check all that apply
Please explain any health conditions listed above:
List any other illnesses, major injuries, or major surgeries:
List any medications, frequency given and amount given:
List feed and supplements: (brand, frequency and amount given)
To make it easier on the pets, we ask that you bring their food.
Describe how your pet behaves for the vet/groomer/farrier:
Do they have to be muzzled/sedated/twitched, etc.?
How does your pet behave in the car/for hauling?
Are there any "bad habits" or fears we should know about?
i.e.: fear of thunderstorms, jumping on counters, etc.
Are there any special treats or traits you would like us to know about?
i.e.: special tricks, loves swimming, etc.
Please, explain in detail why you wish to surrender your pet to Sonia's Sanctuary:
*
By signing below, you agree that you, your spouse and/or any co-owner of the pet(s) described on this form are irrevocably relinquishing to Sonia's Sanctuary legal ownership of said pet(s) on the date of acceptance/surrender. Upon signing, this gives Sonia's Sanctuary total authority to take any necessary actions in our sole judgement on behalf of the pet(s.)
*
This is ONLY an application and does not obligate surrender or promise acceptance. We do ask for a donation and may require a surrender fee, based on the health/care needed for the pet upon surrender.
Office Use Only:
