NEGAS Owner Surrender Form
Owner-surrendered animals are intaken by appointment only.
To make an appointment, please fill out this form as completely as you can, and the Shelter's Intake Coordinator will contact you to make an appointment.
About you:
Which county do you live in? We only serve Franklin and Hart Counties in Georgia!
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Franklin County
Hart County
Somewhere else
We will not be able to accept a pet for surrender from you unless you live in Franklin or Hart County!
PLEASE do not continue this form!
First name
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Last name
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Address
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City
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ZIP Code
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Home Telephone
Mobile
About your animal:
Species
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Cat
Dog
Name
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Actual Age
Sex
Male
Female
Breed
Abyssinian
Affenpinscher
Afghan Hound
African Grey
Airedale Terrier
Akbash
Akita
Alaskan Malamute
Amazon
American
American Bulldog
American Curl
American Eskimo Dog
American Fuzzy Lop
American Sable
American Shorthair
American Staffordshire Terrier
American Water Spaniel
American Wirehair
Anatolian Shepherd
Angora Rabbit
Appaloosa
Appenzell Mountain Dog
Applehead Siamese
Arabian
Australian Cattle Dog/Blue Heeler
Australian Kelpie
Australian Shepherd
Australian Terrier
Balinese
Basenji
Basset Hound
Beagle
Bearded Collie
Beauceron
Bedlington Terrier
Belgian Hare
Belgian Shepherd Dog Sheepdog
Belgian Shepherd Laekenois
Belgian Shepherd Malinois
Belgian Shepherd Tervuren
Bengal
Bernese Mountain Dog
Beveren
Bichon Frise
Birman
Black and Tan Coonhound
Black Labrador Retriever
Black Mouth Cur
Bloodhound
Bluetick Coonhound
Bobtail
Bombay
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flanders
Boxer
Boykin Spaniel
Briard
Britannia Petite
British Shorthair
Brittany Spaniel
Brotogeris
Brussels Griffon
Budgie/Budgerigar
Bullmastiff
Bull Terrier
Bunny Rabbit
Burmese
Burmilla
Caique
Cairn Terrier
Calico
Californian
Canaan Dog
Canadian Hairless
Canary
Cane Corso Mastiff
Carolina Dog
Catahoula Leopard Dog
Cattle Dog
Cavalier King Charles Spaniel
Champagne D'Argent
Chartreux
Checkered Giant
Chesapeake Bay Retriever
Chicken
Chihuahua
Chinchilla
Chinchilla
Chinchilla
Chinese Crested Dog
Chinese Foo Dog
Chocolate Labrador Retriever
Chow Chow
Cinnamon
Clumber Spaniel
Clydesdale
Cockapoo
Cockatiel
Cockatoo
Cocker Spaniel
Collie
Conure
Coonhound
Corgi
Cornish Rex
Coton de Tulear
Cow
Creme D'Argent
Cymric
Dachshund
Dalmatian
Dandi Dinmont Terrier
Devon Rex
Doberman Pinscher
Dogo Argentino
Dogue de Bordeaux
Domestic Long Hair
Domestic Medium Hair
Domestic Short Hair
Donkey/Mule
Dove
Draft
Duck
Dutch
Dutch Shepherd
Dwarf
Dwarf Eared
Eclectus
Egyptian Mau
Emu
English Bulldog
English Cocker Spaniel
English Coonhound
English Lop
English Pointer
English Setter
English Shepherd
English Spot
English Springer Spaniel
English Toy Spaniel
Entlebucher
Eskimo Dog
Exotic Shorthair
Extra-Toes Cat (Hemingway Polydactyl)
Ferret
Field Spaniel
Fila Brasileiro
Finch
Finnish Lapphund
Finnish Spitz
Fish
Flat-coated Retriever
Flemish Giant
Florida White
Foxhound
Fox Terrier
French Bulldog
French-Lop
Gaited
Gecko
Gerbil
German Pinscher
German Shepherd Dog
German Shorthaired Pointer
German Wirehaired Pointer
Glen of Imaal Terrier
Goat
Golden Retriever
Goose
Gordon Setter
Grade
Great Dane
Greater Swiss Mountain Dog
Great Pyrenees
Greyhound
Guinea fowl
Guinea Pig
Hamster
Harlequin
Havana
Havana
Havanese
Hedgehog
Himalayan
Himalayan
Holland Lop
Hotot
Hound
Hovawart
Husky
Ibizan Hound
Iguana
Illyrian Sheepdog
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Italian Spinone
Jack Russell Terrier
Japanese Bobtail
Japanese Chin
Javanese
Jersey Wooly
Jindo
Kai Dog
Kakariki
Karelian Bear Dog
Keeshond
Kerry Blue Terrier
Kishu
Komondor
Korat
Kuvasz
Kyi Leo
Labrador Retriever
Lakeland Terrier
Lancashire Heeler
Leonberger
Lhasa Apso
Lilac
Lizard
Llama
Lop Eared
Lory/Lorikeet
Lovebird
Lowchen
Macaw
Maine Coon
Maltese
Manchester Terrier
Manx
Maremma Sheepdog
Mastiff
McNab
Miniature Pinscher
Mini-Lop
Mini Rex
Missouri Foxtrotter
Mixed Breed
Morgan
Mountain Cur
Mountain Dog
Mouse
Munchkin
Munsterlander
Mustang
Mynah
Neapolitan Mastiff
Netherland Dwarf
Newfoundland Dog
New Guinea Singing Dog
New Zealand
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Forest Cat
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck-Tolling Retriever
Ocicat
Old English Sheepdog
Oriental Long Hair
Oriental Short Hair
Oriental Tabby
Ostrich
Otterhound
Paint/Pinto
Palomino
Palomino
Papillon
Parakeet (Other)
Parrotlet
Parrot (Other)
Paso Fino
Patterdale Terrier (Fell Terrier)
Peacock/Pea fowl
Pekingese
Percheron
Persian
Peruvian Inca Orchid
Peruvian Paso
Petit Basset Griffon Vendeen
Pharaoh Hound
Pheasant
Pigeon
Pig (Farm)
Pionus
Pit Bull Terrier
Pixie-Bob
Plott Hound
Poicephalus/Senegal
Pointer
Polish
Polish Lowland Sheepdog
Pomeranian
Pomsky
Pony
Poodle
Portugese Podengo
Portuguese Water Dog
Pot Bellied
Prairie Dog
Presa Canario
Pug
Puli
Pumi
Quaker Parakeet
Quarterhorse
Ragamuffin
Ragdoll
Rat
Rat Terrier
Redbone Coonhound
Retriever
Rex
Rhea
Rhinelander
Rhodesian Ridgeback
Ringneck/Psittacula
Rosella
Rottweiler
Russian Blue
Saddlebred
Saint Bernard St. Bernard
Saluki
Samoyed
Satin
Schipperke
Schnauzer
Scottish Deerhound
Scottish Fold
Scottish Terrier Scottie
Sealyham Terrier
Selkirk Rex
Setter
Shar Pei
Sheep
Sheep Dog
Shepherd
Shetland Sheepdog Sheltie
Shiba Inu
Shih Tzu
Siamese
Siberian
Siberian Husky
Silky Terrier
Silver
Silver Fox
Silver Marten
Singapura
Skunk
Skye Terrier
Sloughi
Smooth Fox Terrier
Snake
Snowshoe
Softbill (Other)
Somali
South Russian Ovcharka
Spaniel
Sphynx (hairless cat)
Spitz
Staffordshire Bull Terrier
Standardbred
Sugar Glider
Swan
Swedish Vallhund
Tan
Tennessee Walker
Terrier
Thai Ridgeback
Thoroughbred
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Tiger
Tonkinese
Tosa Inu
Toucan
Toy Fox Terrier
Treeing Walker Coonhound
Turkey
Turkish Angora
Turkish Van
Turtle
Vietnamese Pot Bellied
Vizsla
Warmblood
Weimaraner
Welsh Corgi
Welsh Springer Spaniel
Welsh Terrier
West Highland White Terrier Westie
Wheaten Terrier
Whippet
White German Shepherd
Wire-haired Pointing Griffon
Wirehaired Terrier
Xoloitzcuintle/Mexican Hairless
Yellow Labrador Retriever
Yorkshire Terrier Yorkie
Color
Amber
Black
Black and Brindle
Black and Brown
Black and Tan
Black and White
Black/Brown/White Tabby
Black/Grey Tabby
Black/Orange/Grey Torbie
Black/Orange/White Calico
Black Tortie
Blonde
Blue
Blue Tortie
Brindle
Brindle and Black
Brindle and White
Brown
Brown and Black
Brown and White
Buff
Calico
Chocolate
Chocolate Tortie
Cinnamon
Cinnamon Tortoiseshell
Cream
Dilute Calico
Dilute Tortie
Fawn
Fawn Tortoiseshell
Ginger
Ginger and White
Golden
Green
Grey
Grey and White
Grey/Cream
Grey/Orange Torbie
Grey/Orange Tortie
Grey Tabby
Light Amber
Lilac
Lilac Tortie
Liver
Liver and White
Orange Tabby
Orange/White
Red
Ruddy
Seal
Seal Point
Silver
Sorrel
Sorrel Tortoiseshell
Tabby
Tabby and White
Tan
Tan and Black
Tan and White
Torticalico
Tortie
Tortie and White
Tricolour
Various
White
White and Black
White and Brindle
White and Brown
White and Grey
White and Liver
White and Tabby
White and Tan
White and Torti
White/Red
Yellow and Grey
Markings or distinguishing features
Microchipped?
Yes
No
Not checked
spayed/neutered?
Yes
No
Unknown
Up to date on vaccines?
No
Yes
Why do you want to give up this animal? Please be specific.
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How long have you owned this animal?
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Describe this animal's temperament
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Friendly
Shy
Aggressive
Where did you get this pet from?
Is the animal injuried, unhealthy, or have any ongoing medical needs?
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No
Yes
If so, please describe in detail.
Is this pet good with children?
No
Yes
Is this pet good with cats?
No
Yes
Is this pet good with dogs?
No
Yes
Where does this pet stay during the day?
Where does this pet stay at night?
Has this pet EVER shown aggression toward a person or another animal?
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No
Yes
If so, please describe in detail.
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Is this cat litterbox trained?
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No
Yes
Is this dog housebroken?
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No
Yes
