Owner Surrender

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We are dedicated to finding the best, safest and the most appropriate home for your animal.  Undesirable behaviors and medical issues don't necessarily create problems in placement, however, NOT disclosing those problems does.  Dishonest or incomplete answers can undermine the safety and happiness of both your dog and the new adopting family.  If there is anything on this form that you are unclear about or that you are uncomfortable answering, please call us directly at 719-357-6913.

If you have multiple animals, please submit a separate form for each animal.

Name
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Address
Sex
Spayed/Neutered
Is your pet good with children?
Is your pet good with dogs?
Is your pet good with cats?

You understand and agree to the following:
*You are the legal owner of the animal you are relinquishing.

I, undersigned, owner or having control of the animal described above, hereby give ownership of said animal to White Rose Sanctuary to be placed for adoption.

I agree to make all veterinarian records for said animal available to the rescue.

I certify that, to my knowledge, this animal has not bitten or scratched anyone in the past
fourteen days or been exposed to rabies.

I have answered these questions truthfully and to the best of my knowledge.

Please take four good quality, well-lit photographs of your pet and submit them here or email them to us at wolff@wrsanctuary.com with your name and the animal's name in the subject of the email. Videos are also welcome. 

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Clear Signature
Date / Time