Surrender Application

Instructions: Complete the form. We'll review the information and contact you and let you know if we can accept the animal into our program. It will take at least a week, likely longer. If you can't wait until we contact you, please click here to find out what else you can do.

We are not able to take in your dog today.

Houston Area Doberman Rescue is only able to accept pure-bred Doberman Pinschers into our program. If the dog is not a Doberman Pinscher, please contact a local all-breed rescue. It is extremely difficult to place breeds other than Doberman Pinschers through our rescue.

This is what a Doberman Pinscher looks like:
Examples of Dobermans

Surrender Information

It will take us at least a week to respond. If you can't wait, take the dog to your local County Animal Shelter.
We do not accept dogs the same day you complete the form.
We do not to pickup strays, contact your county's Animal Control Office for pickups.
We do not do pickups from you. If the dog is accepted into our program, you will be instructed where to take him or her.

Surrender Category *

Be descriptive. The more information we have, the better prepared we are to make a decision about whether we can accept the dog into our Rescue. Please note: it is very rare that we can accept a Doberman from you the same day you complete this form. We do not to pickups from you or of strays.

Provide details about why are you surrendering this dog. *

Your Relationship to the Dog

Are you the owner or did you find the dog? *

Please finish completing this form to make us aware and then take the dog to one of these animal shelters. They will alert us that a Doberman Pinscher has been dropped off. HADR is unable to accept "found" dogs into our rescue from anyone except legally compliant shelters.

If dog was found, did you post "Found Dog" signs near where the dog was found? *

If dog was found, did you take him/her to a vet to scan for a microchip? *

Current Owner Contact Information

Finder Contact Information

First Name *

Last Name *

Address *

City *

State *

Zip Code *

County *

Home Phone *

Work Phone *

Cell Phone *

Email Address *

Dog Information

Dog's Name (Create one if you don't know) *

Sex of Dog *

Spayed/Neutered *

Microchip Number

Enter the dog's date of birth. *

What is the general age of the dog? *

Actual Age of Dog *

Color of Dog *

Enter the color of the dog *

Dog's Ear Type *

Dog's Tail Type *

Estimated Weight *

Describe any markings (ie white spot on chest)

How long have you owned this dog? *

Where was the Dog acquired? *

What brand of food does the dog eat? *

How often is the dog fed? *

Medical History

Be descriptive. The more information we have, the better prepared we are to make a decision about whether we can accept the dog into our Rescue.

Do you have any medical information on this dog? *

What was the date of the last veterinarian visit? *

Is the dog currently on heartworm prevention? *

What heartworm prevention brand do you use? *

Enter the brand of heartworm prevention this dog is currently taking: *

Which day of the month do you give the heartworm prevention? *

When was the last heartworm test? *

What were the results of the last heartworm test? *

Do you have any vaccine information for this dog? *

What was the date of the last Rabies vaccination? *

What was the date of the last DHLPP/DA2PP vaccine? *

What was the date of the last Bordetella vaccine? *

What was the date of the last Influenza Vaccine

List any health problems, special needs, or injuries

List medications this dog takes regularly (including dosages and frequencies)

Veterinarian Information

Do you know the veterinarian for this dog? *

Veterinarian's Name *

Veterinarian's Address *

Veterinarian's City *

Select the Veterinarian's State *

Veterinarian's Zip *

Veterinarian's Phone *

Veterinarian's Email Address

Bite History

Has the dog ever bitten anyone? *

What was the dog's behavior prior to the bite? *

Where on the person's body did the dog bite? *

Was the skin broken? *

What type of injuries? *

Describe the injury (ie, bite to the person's ear on the left side of the face) *

Was medical attention required? *

What type of medical attention was required? *

Before Bite

For example: The dog was lying on their bed.

What was happening before the bite occurred? *

During Bite

For example: The recipient came up behind dog and was petting her leg, not paying attention to the dog's reaction to being petted.

Please explain what was happening during the bite. *

After Bite

For example: The dog looked at recipient with a concerned look and ran. The dog then came back to the recipient and gave them a kiss.

Please explain what was happened after the bite. *

Personality Traits

Select all the traits this dog has *

Is this dog good with cats? *

Is this dog good with other dogs? *

Would you recommend this dog be placed with children? *

Please explain why this dog should not be placed with children *

Is the dog house trained? *

What is this dog's prey drive? *

This dog will chase: *

This dog gets along with: *

Is this dog destructive in your home? *

Explain how the dog is destructive. *

Has this dog had any obedience training? *

Explain any obedience training this dog has had. *

Additional Information

Please provide any other information to help us place this dog in an appropriate home. Include anything special about this dog that they like or don't like. If you don't know, enter unknown. *

Dog Photos

You must attach at least one photograph of the dog you want to surrender. You can attach up to 2 additional photographs.

Dog Photograph - Required *

Dog Photograph 2 - Optional

Dog Photograph 3 - Optional

Certification, Relinquishment of Rights and Signature

I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT. I HEREBY RENOUNCE ANY AND ALL CLAIM TO THE DESCRIBED DOG. I FULLY UNDERSTAND THAT I WILL NEVER KNOW THE WHEREABOUTS OF THE DOG. WITH THIS INSTRUMENT, AND UPON WRITTEN ACCEPTANCE FROM HOUSTON AREA DOBERMAN RESCUE, THE DOG BECOMES THE PROPERTY OF HOUSTON AREA DOBERMAN RESCUE. I AM IN FULL AGREEMENT WITH THESE TERMS OF SURRENDER.

If you are using a phone or tablet to complete this application, simply sign your name below. If you are using a computer, use your mouse to write your name below.

Signature *

Select today's date *

Click submit once. It may take up to 30 seconds for the screen to change. Do not click submit more than once.

See a list of shelters where you can drop off the dog.