Owner Surrender Form

SURRENDERING YOUR POINTING DOG

There are many circumstances that require people to give up their dogs: death in the family, personal health issues, relocation, financial hardship, etc.

If you feel that it is necessary to surrender your dog, please fill out and submit the release form.

By submitting this form to Pointing Dog Rescue you agree that the information you are providing is truthful and complete, that you agree to be bound by the terms of the Surrender Agreement, and that you agree to hold Pointing Dog Rescue and its officers and volunteers harmless from any and all claims, actions, damages or other liability in connection with the animal being surrendered, this website or any related matters.

Nancy Lane
Foster/Surrender Coordinator
(406) 486-5445

SURRENDER FORM

Name:

Address:

City:

State:

Zip:

Telephone:

Email Address:

1. Dog's Name?

2. Age/Birth Date?

3. Veterinarian Name/Telephone?

4. Shots given/date?

5. Date and results of last Heartworm check?

6. Preventative used?

7. Date and results of last fecal check?

8. Tattoo or microchip #?

9. Housebroken?

10. Signal used to ask to go out?

11. Bad habits (fence jumping, barking, chewing, jumping up, chasing cars, etc.?

12. Special things the dog enjoys?

13. Spayed or neutered?

14. Ever been used for breeding?

15. Has the dog ever bitten anyone?

16. If yes, please give circumstances?

17. How is the dog with other dogs?

18. How is the dog with other Cats?

19. How is the dog with other Children?

20. How is the dog with other Men?

21. How is the dog with other Women?

22. Has the dog been checked for hip dysplasia?

23. Feeding schedule and amount?

24. Medication (Heartworm preventative, etc.)?

25. Reasons for giving up this dog?

26. Have you contacted the breeder of this dog about the problem?

27. What is the name of the breeder?

By submitting this form to Pointing Dog Rescue you agree that the information you are providing is truthful and complete, that you agree to be bound by the terms of the Surrender Agreement, and that you agree to hold Pointing Dog rescue and its officers and volunteers harmless from any and all claims, actions, damages or other liability in connection with the animal being surrendered, this website, or any related matters.

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