pet surrender form

We are so sorry you have a pet in need of rehoming. In order to learn more about your situation and your dog/cat, please fill out this form in detail and we will get back to you as soon as possible. Please note: We are a foster based rescue. We do not have a shelter or facility of our own and welcome owner surrenders based on availability and the pet's personality.

Name

First Name

Last Name

Date of Birth

Email Address

Address (where animal is currently located)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Reason for surrender: why does your pet need a new home?

What is your pet's personality like? Please be as specific as possible (social, friendly, shy, good with kids, not good with other dogs...)

Does your pet have a bite history? (Have they ever bitten another animal or human?)

Is your pet spayed/neutered?

Is your pet up-to-date on current vaccinations and heartworm test?

Date of your pet's last vet exam:

Are you able to provide Animal Lighthouse with a copy of your pet's medical records and proof of spay/neuter?

Please provide your veterinarian's name, address and phone number:

How did you find out about Animal Lighthouse Rescue?

Please provide any other information that may be helpful for us to know when reviewing your application:

In connection with this animal surrender, we request a donation fee to help us offset costs of caring for your pet (foster care, supplies, medical care) Dogs: $300 Cats: $150. Is this acceptable to you?