Rehome / Surrender Request

Rehome / Surrender Request - Dog/Puppy

First Name: *
Last Name: *
Email:
Main Phone #: *
STREET Address: *
City: *
State: *
Zip Code: *
Please checking the appropriate box below (please check only one box):
	This is a FAMILY PET.
	This is a STRAY or FOUND ANIMAL.
Where are you located (FOR OWNED ANIMAL) OR Where was animal found (FOR STRAY ANIMAL)? *	Tyler City Limits Smith County (Outside Tyler City Limits) Other
This animal is a: *	Dog Puppy
How long have you had this animal? *
Animal Name (If Known):
Animal Age / Birthdate (if known):
Animal's Gender: *	Male Female Unknown
Size: *	Small (20 lbs or less) Medium (21-40 lbs) Large (41-60 lbs) Very Large (61 lbs or more)

Description / Condition of Animal: *
Reason for Surrendering: *
Is this pet up-to-date on vaccinations? *	Yes - I can provide vet records No Unknown
Is this pet spayed/neutered? *	Yes No Unknown

Are you able to make a donation to the SPCA of East Texas to assist with medical costs? *	Yes No Not the full amount but I will make a donation to the SPCA of East Texas to help rehome this pet

Does this pet have any known medical issues? *
If answered Yes to above, please explain:
The SPCA of East Texas does not operate a shelter and is 100% foster home based. Therefore, if you are able to foster this pet, it will improve our chances of being able to rehome the pet for you.
If this pet is accepted into our rehoming program, how long are you able to foster it? *	Temporarily (a few days) Short-Term (1-2 weeks until a long-term foster is found) Long-Term (until a permament home is found)

When do you need to surrender this pet? *
***We MUST have a picture of this pet in order to process your application.
YOU MUST CLICK THIS LINK karen@spcaeasttx.com TO EMAIL A PHOTO BEFORE SUBMITTING THIS FORM

ACKNOWLEDGEMENT
By signing below, I acknowledge:
1) That this is a request for the above mentioned animal to be accepted into the SPCA of East Texas rehoming program and does not guarantee entrance into the program;
2) If accepted, this animal becomes the property of the SPCA of East Texas;
3) All decisions involving said animal, including but not limited to adoption, medical, grooming and foster placement will be made by the SPCA of East Texas.
4) If I agree to foster said animal while a permanent home is found, I understand that I may not adopt or relinquish this animal independently and must refer any interested party to the SPCA of East Texas;
5) A week's notice is required to move said animal should I find myself unable to continue to foster.

IF USING A TOUCH SCREEN, please use finger to sign below. TO RESET SIGNATURE FIELD, PRESS THE CLEAR BUTTON BELOW.
*
If NOT using a touch screen, please initial in box below in lieu of signature.
Initials:
Please Type Name (First & Last): *
Date: *