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Surrender Your Dog

Use the form below to submit your surrender application. You can also download and print the application and either drop it off in person at the shelter or email it to casa@camanoanimalshelter.org

Reason for Surrendering
Where did you acquire this dog?
CASA
Friend/relative
Other shelter/rescue
Breeder
Found/stray
Pet Shop
Born in your care

Dog Information

Gender:
Male
Female
Altered/Spayed/Neutered:
Yes
No
Size
Small
Medium
Large
Microchipped?
Yes
No
Don't know

OR

Last time this dog went to the vet:
6 months or less
Within the last year
1-3 years
Over 3 years ago
Does this dog have any health issues or old injuries?
Yes
No
Is this dog on any medication or supplements?
Yes
No
No, but should be
Is this dog on a special diet or have dietary issues?
Yes
No
No, but should be
When is this dog usually fed?
What type of food was the dog fed?
Dry/Kibble
Wet/Canned
Both
This dog is accustomed to:
Where has this dog been allowed?

How much time was the dog kept... (in hours)

Where did you leave the dog when no one was home?
Where is this dog used to sleeping?
What ages of people lived with this dog?

If you checked the box that indicates that the animal has lived with children, please answer the following two questions:

How would you describe the dog's behavior around children?
How would you describe your household?
What type(s) of training has this dog had?
Does the dog know how to?
Has this dog ever bitten, snapped, or growled at anyone?
Yes
No
Do you feel this dog is over protective?
Yes
No
Does this dog chase anything?
Is this dog frightened of anything?
This dog DOES get along with the following animals?
This dog DOES NOT get along with the following animals?

When leashed, does the dog lunge...

...at other dogs?
Yes
No
...at people?
Yes
No
...to play?
Yes
No
Is your yard fenced?
Yes
No
Has the dog repeatedly escaped from your yard?
Yes
No
If yes, how has the dog escaped?
If yes, when does the dog escape?
All the time
When left alone
Other
Is the dog house/potty trained?
Yes
No
Is the dog crate trained?
Yes
No
If there are potty issues has the dog seen a vet to rule out a medical issue?
Yes
No
How often does the dog have accidents in the house?
Once a day
Once a week
Never
Every time dog is inside
What kind of potty training have you tried?
How have you dealt with this problem?

My submitting this form, I attest that the above given information is true and to the best of my knowledge. I am the owner of the above described dog and have the legal authority to surrender/transfer ownership said dog to another party such as C.A.S.A. I give CASA permission to obtain all veterinary records related to the animal listed above.

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