HOME
Adoptees
Adoptables
Puppies
The Litter
Application
Request to Surrender 
adoptables page 2
HOW DO I ADOPT
HOW TO ADOPT
BREED INFO
BREED INFORMATION

Request to Surrender 
Please use this form for any dog that you are requesting to surrender to AYR.

Surrendering your dog is an irrevocable decision; once surrendered, you release your rights as a pet owner. AYR does not return or readopt dogs to the surrendering owner.

Our Foster Coordinator will determine if we have an appropriate home to accommodate your dog's needs.

A representative from AYR will be in contact with you as soon as possible.

This form must be completed in its entirety before we can consider accepting your dog into AYR.


Name:
Street Address:
City:
State:
Zip Code:
Home Phone Number:
Cell Phone Number:
Email Address:
Dog Name:
Dog Age:
Color of Dog:
Gender:
Weight:
Photo of dog:
Breed:
Reason for Surrender:
Any Health Issues:
Care currently given for these Issues:
Last Vet Visit:
Vet name and number:
May we contact your vet:
Up to date shots:


Rabies shot:
Rabies date done:
Parvo/Distemper:
Parvo/Distemper date:
Heartworm Test done:
Heartworm date done:
Spayed/Neutered:
Any additional info on the dog:
Gets along with other dogs:
Gets along with cats:
Gets along with children:
Has dog ever bitten:




Explain bite:
Best way to contact you:
Phone or Email:
Are you willing to donate to help with the vet bills for this Dog:


If so how much:
How did you hear about AYR:
Have you contacted other groups, if so explain:
May we refer your request to another reputable group if we have no one to help you:
Please PRINT this page before submitting.
free hit counter code
Provided by website designers directory.