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Animal Surrender Form Template

Streamline the Pet Relinquishment Process with Ease

If you're handling the difficult task of accepting surrendered pets, an effective form can make the process smoother for everyone involved. This Animal Surrender Form Template is designed specifically for shelters and rescue centers to collect important information from pet owners who need to relinquish their animals. By using this template, you can ensure a clear and organized transfer of responsibility, reduce the burden on staff, maintain records easily, and enhance communication with pet owners. Plus, it's a free printable solution that you can customize as needed-start using the live template today to simplify your intake process!

Full name
Email
Phone
Street address (city, state)
Preferred contact method
Email
Phone call
Text message
Animal name
Species
Dog
Cat
Rabbit
Small mammal
Bird
Reptile/Amphibian
Farm animal
Other
Please Specify:
Primary breed
Sex
Male
Female
Unknown
Age (years/months)
Approximate weight
Color/markings
Microchip number
License/tag number
Spayed/Neutered
Yes
No
Up to date on core vaccinations
Yes
No
Current medical conditions or medications
Last veterinary visit date
Primary veterinary clinic name
Permission to request veterinary records
Yes
No
Has the animal ever bitten and broken skin
Yes
No
Any bite or scratch to a person in the last 10 days
Yes
No
Is the animal currently ill or injured
Yes
No
Typical energy level
Very low
Low
Moderate
High
Very high
Not sure
House-trained or litter box habits
Consistently trained
Mostly trained
Inconsistent
Not trained
Not applicable
Behavior with children under 12
Comfortable
Tolerant
Uncomfortable
Risk of aggression
Not exposed
Behavior with dogs
Comfortable
Selective
Uncomfortable
Risk of aggression
Not exposed
Behavior with cats
Comfortable
Selective
Uncomfortable
Risk of aggression
Not exposed
Destructive behavior when left alone
Never
Rarely
Sometimes
Often
Not applicable
How long have you owned the animal
Less than 3 months
3-12 months
1-3 years
3-7 years
7+ years
Where did you acquire the animal
Breeder
Shelter/Rescue
Found stray
Friend/Family
Pet store
Born in home
Other
Please Specify:
Are you the legal owner with the right to surrender
Yes
No
Is there a co-owner who must also consent
Yes
No
Do all household members agree to the surrender
Yes
No
Primary reason for surrender
Please Specify:
Please describe anything that would help the next home
How soon do you need to surrender
Today
Within 3 days
Within 1 week
Within 2 weeks
Flexible
Are you willing to keep the animal while we seek placement
Yes
No
Can the animal be placed with children under 12
Yes
No
Unsure
Not applicable
Can the animal be placed with dogs
Yes
No
Unsure
Not applicable
Can the animal be placed with cats
Yes
No
Unsure
Not applicable
Items you will provide at intake
Please Specify:
I authorize the organization to assume ownership of the animal upon acceptance of this surrender
Yes
No
I understand placement decisions are at the organization's discretion and may include placement, transfer, or humane euthanasia under policy
Yes
No
I affirm the information provided is accurate to the best of my knowledge
True
False
May we share the animal's photos or story for adoption purposes
Yes
No
Preferred intake date
Preferred time window
Morning (9am-12pm)
Afternoon (12pm-4pm)
Evening (4pm-7pm)
Flexible
Best time to contact you
Morning
Afternoon
Evening
Anytime
Type your full legal name as signature
Date
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Paper art illustration depicting an animal surrender form for an article on FormCreatorAI.

When to use this form

Use this form when an owner needs to relinquish a dog, cat, or small pet to your shelter, rescue, or animal control. It helps you gather identification, behavior, medical history, and clear consent before intake. For a clean transfer, pair the submission with an Ownership declaration form to document authority. If the pet will be listed for adoption, reuse details in a Dog bio update form to build a safe, accurate profile. Staff at the front desk, field officers, and fosters all benefit from having the same facts in one record. The outcome is faster processing, safer housing, and better matches for the animal.

Must Ask Animal Surrender Questions

  1. What is the animal's species, breed, age, sex, color, and microchip or tag number?

    These identifiers prevent mix-ups and support lost-pet searches and licensing checks. If it is a dog, you can verify records against your Dog registration form.

  2. Why are you giving up this pet, and what solutions have you already tried?

    The reason informs triage, counseling, and placement decisions, and it can uncover resources that may keep the pet in the home. If there are welfare red flags, your team can follow up using the Animal abuse survey form.

  3. What medical conditions, medications, vaccinations, allergies, or special diets should we know about, and when was the last vet visit?

    Health details protect staff and other animals, guide quarantine or treatment, and avoid duplicate costs. They also help adopters and fosters continue care without gaps.

  4. How does the pet behave with adults, kids, dogs, cats, and in common situations such as handling, crate time, car rides, and grooming?

    Temperament and triggers let you place the animal safely and write realistic expectations for future caretakers. If the animal is a kitten, these notes map neatly into your Simple kitten adoption form.

  5. Do you certify you have legal authority to surrender this animal and transfer ownership, and can you share proof (ID or purchase/adoption records)?

    Documented consent protects your organization and prevents disputes later. Clear proof also speeds intake and reduces follow-up calls.

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