Animal Surrender Form

Eastern Counties Golden Retriever Club

Rehoming Co-ordinator: Mike Hamilton

tel: 07434 615157

Email: goldenretrieverrescue@hotmail.com

https://www.ecgrc.co.uk/rescue/

Animal Surrender Form

Answering these questions honestly will not stop the Rescue from admitting your animal but will ensure that we are able to provide the correct care for your animal. Please help us to help your animal.

Animal Name
Photograph Please also send images via email to the rescue you are submitting to as large images will not save. Images should be uploaded as jpg or jpeg only
Owner's reason for parting with animal Please give as much detail as possible
Animal current location *
Species *
Breed *
Sex
Age *
Describe your animal *
Is the animal microchipped?
Microchip Number *
Do you give us permission to transfer the microchip to the Rescue?
Can the animal live with children?
If so, please specify ages Please describe the animals behaviour around the children
If no, has the animal met children and what was his/her reaction?
What age groups were any children met?
Can the animal live with dogs?
If so, please specify age and sex Please describe the animal's behaviour around dogs.
Can the animal live with cats?
If so, please specify age and sex
Has the animal lived with animals other than cats and dogs?
If so, please give more details
Is the animal used to men and women? Please state if there is a preference / or if the animal is particularly keen or averse to one gender
What is the animal's reaction if you approach it when it is feeding?
Please describe your animal's feeding regime - brands of food, scraps, dry or tinned, flavours, feeding times and quantities. Any dislikes?
Has the animal been neutered? *
What commands does your animal obey? And what commands are used? For example, sit or sit down; lie or lie down etc.
Where did you get the animal from initially? *
Is the animal upto date with its annual vaccinations?
Date of last vaccination
Current Vet Name *
Vet Address *
Town *
County *
Vet Email Address *
Is the animal housetrained?
Does the animal travel well in cars?
Do you leave the animal alone for any period of time? If so, how long for and do you have concerns about them being on their own?
Has the animal ever been destructive in the house? Please describe
What is the animal's normal routine *
Will the animal give up toys when commanded to?
Would you describe your animal as a gentle player or does he/she like "rough" play? Describe your animal's play activity, eg. favourite game, favourite toy, etc.
How does your animal react to grooming?
How does your animal behave at the vets?
How does your animal react when he/she has done something wrong? How do you "tell him off"?
Does the animal pull on the lead?
Does your animal return when called whilst off the lead?
Person providing information
First name
Surname
Address
Town *
County *
Postcode
Telephonenumber
Emailaddress
Are you willing to make a surrender donation towards the ongoing work of the Rescue, which will include care for your animal ? Our decision whether to accept your pet is not reliant on a donation. A donation is not mandatory but does support Rescues in the work they do
Donation Amount
Are you wishing to surrender ownership of your pet to the Rescue, in full knowledge that the animal will be rehomed and relinquishing all rights to the animal ?
Please type your name in lieu of a signature of your intention to surrender your pet
Date of signature