Dog Surrender Form Please contact us before submitting a surrender form. We require meeting the animal before we agree to accept the animal into our care. We are 100% foster based and can only accept animals if or when we have a suitable foster home. Therefore we do not take aggressive dogs into our program. We are not set up for dealing with those types of behavior issues. We will dog test and food test to verify accuracy of your answers on this form prior to accepting the animal. Completion of this form does not guarantee that we will accept the animal under TRHAP. It is to help us evaluate and determine if we think we can help place the animal. TRHAP expects to spend a minimum of between $150.00 to $1000.00 on food, shelter, medical and other care for each dog we take under our care. If you are able, please consider making a donation to help us care for and find the best home for the animal you are surrending. Dog's Name: Required Dog's Breed: Required Dog's Age: Required Size and Weight of the dog: Required Where did you get this dog? Required Is this dog spayed or neutered? If so, include when this was done. Required List vaccines and dates the vet administered. If none given please state none given. Required We do not recognize vaccines that are bought at a store. We only accept vet records as proof of any vaccine adminstration. List flea and tick preventative and when it was last given: Required List Heartworm preventative and when it was last given: Required Veterinarian: Required Veterinarian's Phone: Required I agree to allow TRHAP to contact the vet for a reference and any information we deem helpful or needed to make a determination in the adoption process. Please contact your vet to ok the release of information to us. Please Initial: Required Why are you surrendering/rehoming this animal? Required Has the dog ever bit someone? If yes, please explain. Required Answer yes or no for the following questions. Explain if needed. Is the dog crate trained? Required Does the dog walk well on a leash? Required Is the dog house trained? Required Does the dog get along with other dogs? Required We test dogs to verify. Does the dog get along with cats? Required Does the dog do well with with children? Babies? Toddlers? Required Is the dog aggressive with people or dogs? Required We test dogs to verify. If yes, please explain. Does the dog guard food or toys or is it food or toy aggressive? Required We test dogs to verify. Does the dog like women? Required Does the dog like men? Required Does the dog bark a lot? Required Is the dog playful? Required Is the dog fearful? Required Is the dog protective? Required If yes, please explain. Is the dog a chewer? Required Is the dog a digger? Required Is the dog quiet? Required Is the dog a couch potato? Required Is the dog always at your side? Required Does the dog have separation anxiety? Required Is the dog an indoor dog? Required Was the dog used for hunting? Required List the dogs favorite activitie: Required List anything the dog dislikes: Required First Name: Required Last Name: Required Address: Required City: Required State: Required Zip: Required Phone: Required Cell Phone: Required Email: Required Re-enter Email: Required My signature below certifies that I am the owner of, or have authority to surrender to TRHAP, the animal described above. I hereby relinquish all rights of ownership and any right to information on the disposition of said animal. I also authorize the release of any veterinary records regarding this animal. I certify that to the best of my knowledge I have disclosed all information about the animal concerning health, behavior, history and anything else that may the safe placement of the animal in a new home. All statements made above are true and correct. Please sign below: Required Date: Required Any additional information you would like to add: