This form must be completed when surrendering a dog into the care of Friendly K9 Rescue.

Print and sign the form.

SURRENDER OF DOG

DOG’S NAME:

DOB/AGE:

BREED:

COLOUR:

DESEXING STATUS:

VACCINATION STATUS:

HEARTWORM TREATED:

FLEA/TICK TREATED:

MICROCHIP NUMBER:
If not microchipped a Statutory Declaration , witnessed by a Justice of the Peace, needs to be presented.

PREVIOUS VET:

 

DOG’S BEHAVIOUR

Dog Friendly                                                                       Cat Friendly

Livestock Friendly – cow chicken  sheep goats    horse   alpacas

Chicken/Duck/Bird – Friendly

Children Friendly (ages)                                                Stranger Friendly

Any/all  health issues/concerns?

Any/all behavioural issues/concerns?

I understand that by completing this form, Friendly K9  Rescue are under no obligation to take this particular dog from me and will assess the dog, details and suitability for foster care and rehoming.

Due to all our foster carers owning their own dogs, we need to carefully assess all incoming dogs, to ensure they will fit with their carers and families.

A surrender fee is payable before accepting surrender.

The amount will be established  after surrender form is completed. Please be aware the fee will vary on each surrender.

I understand and accept that if FK9R accepts the surrender of  the above mentioned dog , I am relinquishing all rights for any claim to the dog now and forever.

I have completed the above form honestly and truthfully in regards to the dogs details, owner information, health  and behavioural stability.

By signing below, I confirm I am the registered and microchipped owner of this dog and have the right to surrender to Friendly K9 Rescue.

 

Name:                                                                                                  Phone No.:

Address:

Identification:                                                                                    Email Address:

Signature: