Surrender Form

Name of owner *

Address of owner *

Email address of owner *

Telephone number *

Name / Age / Sex / Breed of dog *

Does your dog have any behavioural or medical conditions? *

Please give as much detail as you can

How long have you owned your dog? *

Where did your dog come from? *

Please give as much information as you can

How soon are you looking to surrender your dog? *

Please give as much information as you can and why. This will help us assessing your dog, finding a space and the right new home for your dog

Are you able to transport your dog to our rescue in Southport *

We are a small family run organisation and do not offer a collection service

Dog microchip number *

If known and any relevant paperwork

Is your dog neutered *

What is your dog like with other dogs, in the home, on and off lead when out and about *

Please explain in detail

Is your dog vaccinated and do you have their paperwork *

Yes/No Please describe what paperwork you have if any

Has your dog ever bitten? *

Yes/No Please explain the circumstances. This doesn’t necessarily mean we will not rehome but assists us with our assessments and planning and logistics for the dog

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