Surrender | LiveFreeRescue

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Surrender Request

Owner Information

First name*

Last name*

Email*

Phone*

Where are you located?*

City/State

Why are you surrendering your dog?*

Do you have other dogs in your home?*

Yes

No

If yes, please list your other pets.

Dog Information

Dog's Name*

Breed*

Age*

Sex

Male

Female

S/N*

Spayed/Neutered

Unaltered

Is your dog up to date on vaccines?*

Yes

No

How long have you owned your dog?*

Where did you get your dog?*

Is your pup dog-friendly?*

Yes

No

If no, please explain.

Is your pup people-friendly?*

Yes

No

If no, please explain.

Is your pup cat-friendly?*

Yes

No

If no, please explain.

Is your dog house-trained?*

Yes

No

If no, please explain.

Is your dog crate-trained?*

Yes

No

If no, please explain.

What is your dog's temperament?*

Submissive

Dominant

Please explain.

Does your dog have any behavioral issues?*

Has your dog ever bitten another dog or a human?*

Yes

No

If yes, please explain.

I understand that filling out this form does not mean Live Free Animal Rescue will take my dog into the rescue. Live Free Animal Rescue will be in contact within 1 week to go over this information and set up an evaluation to determine if they can take my dog in.

Signature*

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Contact

Pelham NH

Tel: 603-809-5456

info@livefreerescue.com

We are a non-profit registered with the state of New Hampshire.

501(c)3 status approved 2/2019.

EIN 83-3865866

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