Surrender a Dog - Canine Estates

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Adopt a Dog
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About Us
Adopt a Dog
Wish Lists
Donate
FAQs

Surrender Form

Surrender a Dog

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Owner Name *

First

Last

Your Address Line 1 *

Your Address Line 2

Your Address Line 3

City *

State *

Zip Code *

Your Phone Number (including area code) *

Your Email Address *

Name of Veterinarian *

Veterinarian Phone Number (including area code) *

Veterinarian’s Address Line 1 *

Veterinarian’s Address Line 2

Veterinarian’s Address Line 3

Veterinarian City *

Veterinarian State *

Veterinarian Zip Code *

What Is Your Dog’s Name? *

What Is Your Dog’s Breed? *

What Is Your Dog’s Weight? *

We do not accept dogs over 25 pounds.

What Is Your Dog’s Age? *

Is Your Dog Spayed Or Neutered? *

Yes
No

If Not, What Was The Date Of The Last Heat Cycle?

Is Your Dog Current On DHPP And Rabies Vaccines? *

Yes
No

Date Of Last Test For Heartworms: *

Describe Any Health Problems Your Dog Is Experiencing: *

List Any Medications Your Dog Is Taking: *

Describe Your Dog’s Experience With Children Under 6 Years Old: *

How Does Your Dog Respond When Meeting People For The First Time? *

When You Are Away From Home, Where Does Your Dog Stay? *

Where Does Your Dog Sleep At Night? *

Does Your Dog Use Pads In Your Home For Toileting? *

Yes
No

Does Your Dog Use A Doggie Door To Go Outside? *

Yes
No

What Commands Does Your Dog Know? *

Describe How Your Dog Walks With A Leash (Distance And Frequency): *

Has Your Dog Ever Shown Any Food Or Toy Aggression? *

Yes
No

If Your Dog Has Shown Food Or Toy Aggression, Please Describe:

Has Your Dog Ever Shown Aggression, Such As Growling, Snapping, or Biting? *

Yes
No

If Your Dog Has Shown Aggression Such As Growling, Snapping, or Biting, Please Describe:

Has Your Dog Ever Bitten A Person? *

Yes
No

If Your Dog Has Bitten A Person, Please Describe The Event:

Describe The Ideal Adoptive Family For Your Dog: *

(for example: with or without children, other dogs and cats, house atmosphere, etc)

How Did You Hear About Canine Estates? *

Please feel free to add any information that you feel may be relevant or helpful in selecting the best adoptive home for your dog:

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