Surrender Animal Form

About the animal you are requesting to surrender

Name(Required)

Age(Required)

Sex(Required)

Breed(Required)

Is pet spayed or neutered?(Required)

If this is a litter of puppies or kittens, how many are in the litter?(Required)

Please list any behavioral concerns you have (aggression, fearful, not using litterbox, etc)(Required)

Please list any medical concerns this pet has(Required)

Is pet vaccinated within the past year? If so, list what vaccines were given and when(Required)

Is pet on heartworm preventative? If so, list type and when the last dose was given(Required)

Is the dog housetrained? (skip if this is not a dog)

Is the pet an indoor or outdoor pet or both currently?(Required)

Why do you want to surrender this pet to a rescue?(Required)

Are you able to continue fostering this pet until he/she is adopted?(Required)

Are you able to make a monetary donation towards this pet's care if we take him/her in? If so, how much can you donate?(Required)

*On average, our dog and cat expenses are $300 more than adoption fees cover while our horse expenses are $1000-3000 more than the adoption fees cover.

Is there anything else we need to know?

Upload 4 pictures of the pet(Required)

Drop files here or

Accepted file types: jpg, png, jpeg, pdf, Max. file size: 10 MB, Max. files: 4.

Contact Information

First Name(Required)

Last Name(Required)

Address(Required)

Street Address City State ZIP

Phone(Required)

Email(Required)

Was this pet adopted from Crossroads Animal Rescue?

Yes

If yes, please submit the form and then email crossroadsanimalrescuesc@gmail.com to let us know that you are requesting a phone call regarding surrendering a pet adopted from us.

If you do not hear from us within 2 business days, please email again.

Surrender Animal Form