Pet Surrender Form

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Lost Paws Rescue of Texas
P O Box 116256
Carrollton, TX 75011

Name of Pet to be Surrendered*

Name*

First Last

Phone*

Email*

Pet Breed*

Pet Age*

Pet Gender*

Pet Weight*

Spayed or Neutered?*

Yes
No

Has the animal had required shots?*

Yes
No

Date of Shots*

For Dogs: Is the dog taking heartworm medication?

Yes
No

If yes, what kind of heartworm medication and when was it last given to the animal?*

Does the animal stay inside or outside?*

Inside
Outside

Personality Description:

Are there any behavior problems, i.e., biting, submissive urination, digging, etc?*

Yes
No

Is 'yes' – please describe any animal personality issues.

Your reason for wanting to find a new home for the animal:*

Any additional information you might have on the animal:

When dropping my animal for surrender to Lost Paws Rescue of Texas – I agree to sign surrender paperwork for ownership of the above mentioned animal to Lost Paws Rescue of Texas.
If you are fostering the animal and you decide to keep him/her, you agree to pay the adoption fee $200 to cover any and all medical expenses incurred by LPRT to the animal.

Questions or like to give us other info? Please state them here.

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Lost Paws Rescue of Texas Pet Surrender Form

Surrender Form