Owner Surrender Form
*****Before you Continue*****
Please remember that we cannot accept owner surrender Dogs all the time.
We concentrate on saving dogs that need our help in the
Evansville area, and they are in abundance so we are never without dogs to save.
Even when you are in the Evansville area, we give priority to dogs that
are presently in animal controls and shelters. Owner give ups are accepted only when space is
If this dog was originally adopted from us then it will need to be returned to us
as agreed upon when the dog was adopted.
  • Personal Information

  • - -
  • I certify that the information provided on this form is true & correct. I understand that an
    physical evaluation of the dog by an experienced rescue volunteer will be required before we
    accept surrender. If upon inspection we find that information
    contained in this surrender form to be false,
    We retain the right to turn down acceptance of the surrender at anytime during the evaluation.
    I the undersigned am applying to owner surrender my dog :
    freely and with good will.
  • Dog Information:

    We reserve the right to refuse acceptance of any Dogs. Acceptance is based on many criteria, one
    of which is space availability.
  • Check all that Apply.
  • Check all that apply
  • Check all that apply
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