WEBSITE SURRENDER FORM

WEBSITE SURRENDER FORM - animal

A form that can be filled out by an owner to provide as much detail as possible on the dog/s that they wish to surrender to AAPS.

Are you the owner of the animal that is needing to be surrendered? *
Describe why you are filling out the surrender form on behalf of the owner
Your First Name
Your Surname
Your Phone Number
Owner's First Name *
Owner's Last Name *
Phone Number *
Email Address *
Street Address *
Suburb *
Postcode *
What is the reason for needing to surrender your animal? *
Name of animal *
Species of animal *
Breed/s *
Age (approximate) or Date of Birth *
Sex *
Is your animal desexed? *
Is your animal microchipped? *
Please provide the microchip number
How long (approximately) have you had this animal? *
Describe how this animal first entered your care (e.g. from a breeder, friend, gumtree etc.) *
Has your animal been vaccinated within the last 12 months? *
Please attach a copy of the most recent vaccination certificate (within the last 12 months)
does your animal like travelling in a car *
Does your animal have a regular Vet? *
What is the name of their regular Vet?
Has or does your animal have any medical issues, allergies or had any surgery? *
Describe the medical issues, allergies or previous surgeries
Is your animal on any ongoing medications? *
Describe what these ongoing medications are and how they need to be given (e.g. orally, with food, in the morning etc.)
Is your animal allowed inside your house? *
Where is your animal kept during the day? *
Where is your animal kept during the night? *
Is your animal toilet trained? *
On average, how many hours is your animal left alone? *
Describe the type of exercise that your animal gets, and how often *
How does your animal behave/react to being groomed? *
Describe how your animal behaves when visiting the vet *
How does your animal behave around children? *
Has your animal ever lived with any other animals? *
Please describe the species of animal that your dog has lived with (e.g. dogs, cats etc.) as well as each of their ages (during the time that your dog lived with them), whether they were male or female and their breeds
Can your animal be left alone without human company? *
Describe what happens if your animal is left alone without human company
Does your animal need the company of another animal? *
Describe what animal/s
Has your animal ever shown aggression toward people? *
Please describe
Has your animal ever shown aggression to any other animals? *
Please describe
Is your animal destructive? *
Describe what your animal likes to destroy, and what circumstances causes them to become destructive
*	Please check that you understand this is not an acceptance of your pet into our care