EmailMe Form - Pet Surrender Request

First & Last Name *

Phone *

Email *

Please ensure you have access and regularly check this email address, as we generally reach out by email first.

Address *

City, Zip Code *

Do you live within Fairfield County? (We are unable to accept surrenders from outside of Fairfield County) *

Yes

Number of pets to surrender *

Type of Pet(s) *

Breed of Pet(s) (If Known) *

Age of Pet(s) *

Sex of Pet(s) *

Has the pet been spayed/neutered? *

For dogs, estimated weight: *

Reason for Surrendering *

Do they ever become toy or food aggressive? *

Have they ever bitten or attacked anyone? *

Where did you originally get the pet(s)? *

How long have you had the pet(s)? *

If this pet was adopted from another rescue/shelter or acquired from a breeder: did you contact them to see if they will accept the pet back? *

Can the pet(s) easily be caught, picked up or carried, or generally handled? *

How does the pet(s) do with other animals? *

How does the pet(s) do with children? *

Does the pet(s) live indoors or outdoors? *

When are you needing to rehome the pet(s)? *

Does the pet have any past or current medical concerns or conditions? *

Is there anything else we should know about the pet(s)? *

Photo of Pet(s) *

Depending on resolution and size of the image, you may reach the maximum file size allowed for this form. If this happens, please email the remaining images to: info@fairhumane.org

By submitting this form, you acknowledge:

Completion of this form does not guarantee that we will be able to accept your pet. Our facility has limited space and resources, so we are not always able to accept new animals.

You should continue seeking private rehoming and other rescue resources.

If at any time during the intake, it is determined that the pet does not meet our health and temperament requirements, we will decline to accept the animal.

We are unable to accept feral, stray, or outdoor cats unless they have a life threatening injury or illness requiring immediate veterinary care. *

Yes