WISE Animal Rescue Surrender Application
Owner's Information
First Name*
Last Name*
Date of Birth*
Street Address*
Zip Code*
Home Phone
Cell Phone*
Work Phone
Are you the owner of the animal?*
If no, where is the owner?
Pet's Information
Pet's Name*
Date of Birth
Pet's History
How long has this pet lived with you?*
Where did you obtain the pet?*
If from a breeder or rescue group, did you contact them before surrendering your pet here?*
Why are you surrendering your pet?
Please explain why you are surrending your pet.*
Who is your current veterinarian?*
Is your pet current on his/her rabies vaccination?*
Is your pet current on his/her distemper vaccination?*
Date of last rabies vaccination*
Date of last distemper vaccination*
Does your pet have any current health issues?*
Please explain the current health issues.
Does your pet have any past health issues?*
Pet's Behavior
When left alone, does your pet:*
Is your pet crate-trained?*
Is your pet house trained?*
How does your pet greet strangers?*
How does your pet greet other animals outside of the home or in general?*
Has your pet had any experience with children?*
Would you recommend your pet to be placed in a home with children?*
Has your pet ever bitten or nipped you or anyone else?*
Did the bite(s) break skin?*
Was there stitches?*
Please explain the details of the bite.*
Has your pet lived with other animals?*
Sizes of other animals.
Has your pet ever fought with another animal?*
Please explain.
Are there areas on your dog's body that he/she does NOT like to be touched?
If touched in the above place(s), how does your pet respond?
Please tell us about your pet's "bad behavior" or fears.*
Is there anything specific about your pet that you would like to share to make the transition easier?*
What is your pet's potty schedule?*
What is your pet's meal schedule?*
Where does your pet sleep? Describe sleeping habits.*
Describe the ideal home for your pet.*
Have you consulted with a professional trainer about your pet?*
Do you understand that once you surrender your pet, he/she becomes the propter of Wise Animal Rescue?*
Do you understand you will not get your pet back after he/she is surrendered?*
Do you understand that you will be expected to make a monetary donation to help care for your pet once surrendered?*
Please be aware that once a pet is surrendered, it becomes the property of Wise Animal Rescue.
Certain unforeseen circumstances may warrant euthanasia.
By hitting SUBMIT APPLICATION, I certify that the above information is true and accurate to the best of my knowledge and I understand that my completion of this form in no way obligates WISE to accept my dog into the rescue. By submitting this application, I authorize WISE to contact my veterinarian and contact anyone listed.
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