Surrendering a pet - Animal Welfare League of Charlotte County

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3519 Drance St. | Port Charlotte, FL

941.625.6720

We highly recommend that you list your pet up for adoption on our website on the Community Pets page. Please click the link and follow the instructions on the new page.

Pet Surrender Form

Is this request an emergency? *

Yes
No

Name *

First

Last

Email *

Please enter your email, so we can follow up with you.

Phone *

In which county do you live in? *

County *

Why are you surrendering the pet? *

Provide as much detail as possible

Pet's Name *

Pet's Age *

Species *

Cat
Dog
Other

Species *

Gender *

Female
Male

Breed *

Is the pet spayed/neutered? *

Yes
No
Don't know

Is the dog on heartworm preventative? *

Yes
No

How did you acquire the pet? *

When did you acquire the pet? *

Who is your present veterinarian? *

Name and phone number

Does the cat have any health issues or previous injuries?

Yes
No

Please explain

If we could help resolve your reason for surrendering the pet, would you be willing to keep him/her? *

Yes
No

May we contact your veterinarian for medical records? *

Yes
No

What was the date and reason for your last visit? *

Is the pet on medication or a special diet? *

Yes
No

Please describe:

Where does the pet spend most of his/her time? *

How long does the dog spend outdoors at a time? *

Where does the pet sleep? *

What are the pet's favorite toys? *

Does the cat use its litter box? *

Yes
No

Why not? *

Where is the cat kept? *

Indoor
Outdoor
Both

Is the dog crate trained? *

Yes
No

Is the dog leash trained? *

Yes
No

How many hours is the dog left unsupervised? *

Where does the dog stay when no one is home? *

Has the pet ever lived with other animals? What species? *

Is the pet friendly with the following? *

Men
Women
Children under 10
Children under 5
Seniors

How would you describe the pet's temperament? *

Friendly
Over friendly
Scared/fearful
Neutral
Playful
Aggressive

Please check the following boxes if you feel the pet qualifies.

Is the dog overly protective of the following? *

Family
Property
Food
None

Has the dog ever bitten, snapped or growled at anyone? *

Yes
No

Describe

Has the dog ever been to canine obedience training? *

Yes
No

Does the dog fear any of the following? *

Thunderstorms
Fireworks
Loud noises
Hats
Glasses
None of the above

Does the dog escape from a fenced yard? *

Yes
No

What is the pet favorite brand of food? *

Which does your cat eat?

Canned food
Dry food

How often is your pet fed? *

What type of treats does your pet enjoy? *

Please check all that apply: *

Swims
Digs
Climbs
Chews
Bites
Jumps on people
Destructive
Likes car rides
Sickness
Urinates in house
Defecates in house
None of the above

Please check all that apply *

Scratches
Climbs screens
Chews
Aggressively bites
Play/love bites
Destructive
Urinates in house
Defecates in house
None of the above

Please make any comments on your pets behavior or any other important information not stated above that will help us find your pet the best suitable home possible. *

Do you agree that this form is completed to the best of your knowledge? *

Yes

This form was completed by the pet previous owner. AWL cannot guarantee its accuracy *

Yes

Upload a photo of the pet you want to surrender *

Click or drag a file to this area to upload.

Comment

941.625.6720
info@awlshelter.org
3519 Drance St, Port Charlotte, FL 33980
EIN: 59-1146309

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