Surrender Inquiry Form

*READ CAREFULLY* I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the subject of this surrender form, hereinafter referred to as “the animal.” I certify that no other person has a right of property to the animal. I understand that by surrendering my property rights to the animal, the animal may be transferred into the custody of Friends of Duke Rescue. I certify that the animal has/has not bitten or scratched a human or another animal within the past 10 days. *I understand that filing out this form does not transfer ownership of the animal to Friends of Duke Rescue. I understand that once I relinquish the animal (separate documentation required), the animal will not be available to be returned*. I certify that I have read and understand the terms of this Animal Surrender Form. Please complete the sections below. Please note if there is more than one animal being surrendered, there will have to be a surrender form filled out for each individual animal. There is a required surrender fee(donation). This fee will help aid in the cost of vetting for the animal.

Disclaimer-If you are being dishonest about any information; health of animal, aggression history, etc - you are liable for any damages. Please be honest and give us as much information regarding the animal as you can. This will not only help us in placing your animal but will also help in them having a successful future.

Name: *
Drivers License #(please include a copy of your photo ID): *
Photo ID: *
Address: *
Phone Number:
Are you able to be the foster until placement can be found? *	NoYes
Email address:
Reason for surrender, Please give as much detail as possible: *
Surrender Type: Example: Owner surrender, Abandoned, Stray: *
What steps have you taken for rehoming your pet before reaching out to FDR? Have you contacted any other rescues? *
Has the animal been microchipped? If yes please include microchip #:
Current Vet Contact Information: *
Is the animal up to date on vaccines/preventative care? If yes please send all records to FDR:
Does the animal have any immediate medical concerns that you are aware of?
Species: *	Bird Camel Cat Chicken Chinchilla Cockatiel Dog Donkey Dove Ferret Gerbil Goat Goldfish Goose Guinea Pig Hamster Hedgehog Horse Llama Mouse Owl Pig Pony Rabbit Rat Snake Terrapin Tortoise
Animals Name: *
Breed:
Approximate Age:
Has the animal been spayed or neutered?	NoYes
Does the animal get along with other Dogs?	NoYes
Does the animal get along with Cats?	NoYes
Does with animal do well with children?	NoYes
Has the animal ever showed agression or bitten anyone? If yes please explain: *
Please give a description of your animals personality, likes and dislikes: *
Please include a photo of your animal:
Signature: *	Clear

Things to remember: • FDR requires a surrender fee (donation). This will aid in the cost of vetting for the surrendered animal • FDR is a foster based organization. This means we have to put in a lot of work to rehome these animals and are limited on placement. Though we want nothing more than to help every animal in need, our rescue cannot guarantee help in urgent situations. • Ownership of the pet will legally transfer to FDR at the time of surrender, NOT at the time of filing this form • We ask that only legal owners of the animals surrender them to FDR • FDR ONLY accepts dogs and cats for surrender • We ask that you include all medical records upon surrender or authorize FDR to contact your veterinarian to obtain these records • FDR does not guarantee the surrender of the animal. Though we will do our best to help