Surrendering Your Pet

YOU MUST COMPLETE COMPLETE ONLINE OWNER RELINQUISH FORM BELOW. WE WILL NOT DISCUSS REHOMING YOUR ANIMAL UNTIL THIS IS COMPLETE!   ALLOW UP TO 10 DAYS FOR A RESPONSE

Releasing your pet to ATLB Rescue can be a difficult decision to make. We would like you to know that we understand how hard it can be to relinquish a pet. We appreciate your choice to surrender your animal responsibly so that he or she will be safe and humanely cared for.
 
Animal surrenders at ATLB Rescue are handled as quickly as possible. We do require you to complete the ONLINE OWNER RELINQUISH FORM BELOW
before any arrangements can be made. Keep in mind we do not have a Shelter Building and we can only take in animals if we have foster homes available.

 
As a private, nonprofit organization dependent on community contributions, we request a monetary care donation when an animal is surrendered to us. The suggested donation range is $25-$400, although it is not required to contribute this full amount. All donations are greatly appreciated and help to offset a portion of the cost of caring for the hundreds of animals we receive each year.

 

OWNER RELINQUISH FORM

Your Name: (First & Last)
Spouse or Co-App Name
Address
City, State, Zip Code
Email Address:
Home Phone:
Cell Phone
Current Vet's Name, Address and Phone Number
Dogs Name
Breed
How long have you owned this dog?
Why is dog being relinquised? Explain in great detail!
Is this dog housebroken?
If yes, how does he tell you he needs to go out
If no, please explain in detail how often accidents occur
How have you delt with this problem? Paper trained Crated
Checked w/vet for medical problem
Allowed dog in certain areas
Kept dog outside
Diapered
Just dealt with it
Are accidents usually
Has your dog attended any training classes?
If yes, what types puppy class
obedience class
home training agility
protection
Does your dog know any tricks? sit
stay
come
lie down
heel
walk nicely on leash
ride quietly in car
Fetch
Other
Explain other tricks
Does the dog get into trash if unsupervised?
Will the dog get onto counters if unsupervised?
This dog is frightened of men
women
teenagers
children
thunder
fireworks
vacuums
sirens
appliances
trucks
water
hands
feet
boots
rolled newspaper
Other
Explain other
Is there anything that would make this dog show aggression towards people?
If yes, please explain in detail
Is your dog up to date on vaccines? And can you prove it?
County Vaccine was Given
Rabies Tag #
Additional Vaccines & Date Given
Is your dog on heart worm preventitive?
If yes, what brand and last date given?
What is the last date a heartworm test was done?
Male or Female?
Has your dog already been fixed?
Is your dogs ears cropped?
Is your dogs tail docked?
Age or birthdate of dog?
Upload a recent photo
Is your dog micro-chipped?
If yes, What Brand and Chip #
Where was this dog aquired? Shelter - Rescue
Friend - Family
Pet Store
Newspaper - Online
Found - Stray
Born at Home
If shelter - rescue, provide the name of the shelter - rescue?
If from a breeder, provide name of breeder
Please describe in detail this dogs personality
What is your level of expertise with dogs?
Where was the dogs MAIN living area? Whole House
Kitchen
Basement
Backyard
Crate
Garage
Tied outside
Explain in detail the number of hours the dog was kept inside / outside / unsupervised
Where was the dog kept when home alone? Crate
Run of house Laundry room
Kitchen
Garage
Outside
Basement
What is this dogs outside behavior? digging
barking at outside interests barking to come in chewing plants
Visiting neighbors
Using small pool
Jumping at fence
Jumping over fence
Digging under fence
Sunbathes
Plays with toys
Howls
If loose, your dog will Stay in yard
Stay in yard only if owner Present
Wander to the neighbors
Pester neighborhood animals
Get into the garbage
Come home on its own
Run away
Dog will chase People
Children Vehicles
Joggers
Bicycles
Cats
Skateboarders
Rollerbladers
Livestock
Birds
Wildlife
A Ball
A Frisbee
Did this dog interact with other pets?
If yes, please explain in detail his temperment with both
Who did this dog live with / interact with? men
women
seniors
Infant Children ( Birth - 8 yrs)
Children (10 and under)
Children (10 and up)
Where did this dog sleep? Owners’ bed
Owners’ bedroom
Dog bed
Couch
Garage
Crate
Porch
Outdoors
Please list ages of children (seperated by commas)
Select the dogs behavior around adults Friendly
Shy
Playful
Fearful
Aggressive
Snappy
Tolerant
Overly affectionate
Over protective
Please describe an example of behavior around adults
Select the dogs behavior around kids NEVER BEEN WITH KIDS
Friendly
Shy
Playful
Fearful
Aggressive
Snappy
Tolerant
Overly affectionate
Over protective
Please describe an example of behavior around kids
Many children are bitten by dogs each year, would you recommend that this dog be placed with a young child?
If No, what age groups do you recommend for this dog?
If a child goes near the dog when it is eating, chewing a bone, playing with a toy, would the child be in danger
If yes, please explain
Has this dog ever bitten, snapped or growled at anyone?
If yes, explain in DETAIL
Please explain in detail the BEST qualities - traits dog has.
Your Age Group
Are you prepared to pay a owner surrender fee for the ongoing care and medical needs of this dog until their forever home is found?
If yes, what amount are you comfortable donating for the vetting an ongoing care of this animal until it can be placed in its forever home $None$
$25
$50
$75
$100
$150
$200
$300
$400
Please give us 1 NON family reference. Name, phone number, address and relationship:
Please give us 1 family reference. Name, phone number, address and relationship:
How did you hear about ATLB Rescue?
As owner, or custodian acting in good faith, I give the above-described animal irrevocably to All Those Left Behind Animal Rescue, Inc. or whatever disposition All Those Left Behind Animal Rescue, Inc. deems best. My signature waives any and all further rights of ownership to this animal. I understand that All Those Left Behind Animal Rescue, Inc. has NO further obligation to inform me of this animal’s final disposition or furnish me with any information on the new adoptive home of this animal.

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