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Owner Surrender Form

Owner Information

Do you live in Colorado, Southern Wyoming, Northern New Mexico, or Western Kansas? At this time we are only taking surrenders in CO and surrounding areas.
Yes
No

Unforunately, we no longer can support rescue efforts in AZ or the PNW.

Multi-line address

Dog Information

What breed is your dog? We can only accept the below options.
Dog's sex
Unaltered male
Neutered male
Unaltered female
Spayed female

Examples: Breeder, Born in my home, found as a stray, shelter, rescue, pet store, internet posting, friend or relative

Medical History

Has the dog been seen by a Veterinarian in the past year?
Yes
No
Uncertain
Is the dog current on vaccinations and wellness checks? Check all that are current
Has the dog ever been diagnosed with or any of the following symptoms? (Check all that apply)

Behavorial History

How would you describe the dog most of the time? (check all that apply)
How does the dog like to play? (check all that apply)

Lifestyle and Home Life

What areas of the home does the dog have access to? (check all that apply)
Where does the dog spend most of his/her time? (check all that apply)
How lively is your household?

Training history

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