Surrender Inquiry

All questions marked with the red asterisk must have an answer in order to submit your application.

*If your dog was adopted from Helping Hounds you will not need to fill out the form. Please call the rescue at 315-446-5970 to talk with staff about returning the dog.

Contact Info
First Name *
Last Name *
Street Address *
City/ Town *
State *
Zip Code *
Primary Phone *
Secondary Phone
Email *
About Your Dog
Dog's name *
What is the dog's primary breed? *
Dog's age (Please specify years, months, or weeks) *
Dog's sex *	Female Male
Is the dog spayed/ nuetered? *	Yes No
Dog's weight? *
Please describe the reason for the dogs surrender. *
How long have you owned the dog? (Please specify years, months, or weeks) *
Where did you get the dog? *
If you answered rescue, shelter, or other please specify where the dog came from.
Is your doog good with... (Select all that apply) *
Are there other pets in the home? I yes please list them here. *
Are there any children in the home? (Select all that apply) *
Has the dog been seen by a veterinarian? *
Name of the vet/ clinic that the dog been to. *
Veterinarian's phone *
What current vaccinations does the dog have? * Select all that apply
I understand that i need to email a copy of my dogs medical records to adoption@helpinghoundsny.com *
Please include a photo of the dog *
Have you tried to surrender your dog to any other shelters/rescues? *
If yes, what organizations have you tried? *
What reason did the organization give as to why they couldn't help your dog? *
By submitting this form you understand Helping Hounds Dog Rescue will be contacting your vet. You authorize that your vet can share all records about your dog and your dog's medical history with Helping Hounds Dog Rescue.

Surrender Inquiry

Contact Info

About Your Dog