OWNER SURRENDER FORM

Please complete this form if you are considering the surrender of your dog. We realize this form is a bit lengthy, but please fill it out as completely as you can. It will help us better suit the needs of your pet.

Surrendering your dog is an irrevocable decision; once surrendered, you release your rights as a pet owner. Milo’s Dog Rescue of South Florida does not return or re-adopt dogs to the surrendering owner. However, we also know that surrendering your pet can be an emotional experience and we will do everything we can to help facilitate a comfortable transition for both you and your pet.

A representative from Milo’s Dog Rescue of South Florida will be in contact with you as soon as possible.

Upload Picture

If Possible Please Include The Photo of your Pet

Max. file size: 512 MB.

YOUR INFORMATION

Drivers License #(Required)

Date of birth(Required)

E-Mail Address:(Required)

Phone(Required)

Alternate Phone:

Why are you surrendering your pet?(Required)

How long have you had this pet?(Required)

Where did you get this pet?(Required)

DOG'S GENERAL INFORMATION

Name:(Required)

Breed:(Required)

Age:(Required)

Current Weight:(Required)

If yes, provide microchip #

What type of food do you feed your pet?(Required)

Is there any type of food/treat this dog particularly likes?(Required)

If yes, please explain:(Required)

DOG'S MEDICAL INFORMATION

If yes, please explain:(Required)

Explain:(Required)

Your current veterinary clinic:

Name:

Phone:

Other medical information you want to share with us:

DOG'S BEHAVIORAL INFORMATION

Does your pet have any of the following behavior issues? Please explain each issue(please be honest, it will let us know what things we should work on with the pet).

If Explain:

Explain

Explain:

Do you understand that you completely give up the ownership and all rights to this animal when you surrender your animal to Milo's Dog Rescue of South Florida. Once the animal is surrendered, we will decide if we can place the animal up for adoption. Ideally, we would like to place all animals in new homes; however, we cannot guarantee temperament tested by our staff soon after they received to determine if they are suitable for adoption.

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Date(Required)

Signature:(Required)

Surrender Form

OWNER SURRENDER FORM

YOUR INFORMATION

DOG'S GENERAL INFORMATION

DOG'S MEDICAL INFORMATION

Your current veterinary clinic:

DOG'S BEHAVIORAL INFORMATION

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