OWNER SURRENDER FORMPAWS Shelter of Central Texas

OWNER SURRENDER

"*" indicates required fields

This form should be used by persons seeking to re-home their pets. We are aware this form is long and can seem intimidating. Please know that it is in the best interest of your pet to fill it out as completely as possible.

If you have multiple pets, you will need to fill out a separate form for each.

PLEASE NOTE: The intake process requires a scheduled behavior/medical evaluation to be performed by a PAWS staff member for each animal before they are eligible for our adoption program.
Thank you.

In which county do you reside?*

Hays County

Blanco County

Other

**ATTENTION**

Please note that due to renovations at our Kyle Campus, our space has been drastically limited. Wait times for owner surrendered animal acceptance could be a minimum of 2-3 months. If you need immediate rehoming assistance, we recommend contacting your county animal control facility or another rescue.

**ATTENTION**

Due to renovations at our Kyle Campus, our space has been drastically reduced. We are currently only accepting surrender requests from Hays or Blanco County residents. We recommend seeking assistance from your local municipal shelter or other local rescues.

Date*

MM slash DD slash YYYY

Name*

First Last

Address*

Physical addresses only.

Street Address City State ZIP Code

Phone*

Email*

PET DESCRIPTION

Please provide us with details about your pet.

Species:*

Please choose one.

Pet's Age*

Please approximate if you are unsure.

Pet's Name

Gender*

Color:*

Please be descriptive.

Coat Length*

Breed:*

If the dog is a mixed breed, please list which breeds the dog most closely resembles.

Breed / Description*

Please describe the coat patterns of the cat if no breed is obvious. (i.e. tabby, calico, etc.)

Upload a photo of your pet, if available.

Max. file size: 512 MB.

OWNERSHIP INFORMATION

Please tell us about how you've come to possess this pet.

Why are you seeking to re-home this pet / these pets?*

Please be as descriptive as possible. The more information provided, the better chance we have at finding a suitable home for this pet. Additionally, detailed information may expedite the surrender process.

How long have you owned this pet?*

Where did you originally get this pet?*

Where did you originally get this pet?

Which shelter?*

Which shelter?

***Austin Pets Alive! will take back any adopted pet if the adoption does not work out for any reason. Please e-mail adopt@austinpetsalive.org to start the return process. Please specify the problem you are having with your pet so they can assist you quickly.

Contact cat-behavior@austinpetsalive.org or dogbehaviorfollowup@austinpetsalive.org if you are having behavior concerns that you hope to resolve.***

***If you adopted your pet from PAWS Shelter of Central Texas (FKA PAWS Shelter and Humane Society), you may return the pet immediately. Please email intake@pawsshelter.org for more details about returning your pet. You may also call 512-268-1611 and someone will return your call within 24 hours.***

To your knowledge, has this dog ever bitten a person or animal in a non-playful manner?*

Please answer honestly and provide details of any incidents. A bite incident will not necessarily disqualify a pet for surrender but it does help us find suitable homes for these pets. Select all that apply.

Yes, a dog

Yes, a cat

Yes, a person

Other

Please explain the bite incident(s) with a dog.*

Please describe the number of bites, severity of the bite(s), any provocation, and the circumstances surrounding the bite incident. Please describe all separate bite incidents.

Please explain the bite incident(s) with a cat.*

Please describe the number of bites, severity of the bite(s), any provocation, and the circumstances surrounding the bite incident. Please describe all separate bite incidents.

Please explain the bite incident(s) with a person.*

Please describe the number of bites, severity of the bite(s), any provocation, and the circumstances surrounding the bite incident, age of person bit. Please describe all separate bite incidents.

What other bite incident(s) has this pet been involved in?*

Please describe the number of bites, severity of the bite(s), any provocation, and the circumstances surrounding the bite incident. Please describe all separate bite incidents.

Did any of the victims (human or animal) require medical treatment/care from the bites they sustained from this dog?*

Yes

Unsure

Please provide as much detail as possible on extent of medical treatment/care required.*

If available, please provide any photos or documents you have from the bite incident(s).

Drop files here or

Max. file size: 512 MB.

HOME LIFE

Help us learn what home life is like for this pet and what they are most familiar with.

Housing Type:*

Single family home with fully fenced yard

Single family home without a fully fenced yard/no yard

Apartment

Townhome/Duplex with fully fenced yard

Townhome/Duplex without fully fenced yard/no yard

Other

What type of housing is this pet most familiar with?*

When you are at home, this dog spends most of the time:*

Mostly Indoors, free roaming

Mostly Outdoors

Indoors or outdoors with a doggy door

Outdoors only

Other

Other:

Is the dog's routine different at night? If yes, please elaborate.

When you are away from home, this dog spends most of the time:*

Indoors, free roaming

Indoors, confined to one room or area

Indoors, crated

Indoors or outdoors with a doggy door

Outdoors only

Other

Average number of hours this dog is left home alone on a typical day:

Is this dog crate trained?*

Yes, crate trained overnight

Yes, crated when home alone

Yes, crated for car rides

No, this dog reacts poorly to being crated

Unsure, this dog has never been crated

Other

Other:

Does this dog have difficulties when left alone, even for short periods of time?*

Yes

Unsure

What are some of the behaviors the dog exhibits when alone?*

Has bathroom accidents in the home

Tries to escape

Destroys household items

Destroys blinds or doors

Barks/whines constantly

Paces/pants constantly

Chews/digs up flooring near exits in the home

Other

Other:

Did any of the following changes in the home or dog's life/routine occur around the same time the issues noted above began?*

No changes to the home, environment, or routine

This issues have been constant entire time owned

Person moved out of home

New person moved into home

Family member became pregnant or had a baby

New work schedule

Moved into new home

Dog is left alone for more hours each day

Owner is home more often than normal

Loss or death of another pet

New pet added to the household

More stress in the household

Other

Other:

Please elaborate on any challenges this dog has with being left alone or crated, as well as what you have done to help/correct the behavior. Please note any improvements made.

How many people typically live in the home?*

What are the age ranges of all household residents?

Please select all that apply.

Adults 65+

Adults 25-64

Adults 18-24

Teenagers 13-17

Children 10-12

Children 5-9

Toddler 1-4

Infant 0-12 months

How many children, under the age of 12, are in the home?

How would you describe this pet's behavior towards the children?*

Please select all that apply.

Enjoys petting

Calm, gentle

Plays nicely

Jumps on/knocks down

Ignores

Nippy/mouthy

Avoids or hides

Fearful

Growls

Prefers certain kids over others

Barks at

Shows teeth

Snaps at (no contact)

Lunges

Bites (contact made)

Guards items/toys/food/people/spaces

Other

Other behaviors around children:*

Please elaborate on this pet's behavior around children, in the home or otherwise.

How would you describe this pet's behavior towards adults?*

Please select all that apply.

Enjoys petting

Calm, gentle

Plays nicely

Jumps on/knocks down

Ignores

Nippy/mouthy

Avoids or hides

Fearful

Growls

Prefers certain kids over others

Barks at

Shows teeth

Snaps at (no contact)

Lunges

Bites (contact made)

Guards items/toys/food/people/spaces

Other

Other behaviors around adults:*

Please elaborate on this pet's behavior around adults, in the home or otherwise.*

Frequency of visitors (includes family, friends, and service professionals)?*

Almost daily

1-2 times per week

1-2 times per month

Once every couple of months

Special occasions only

How does this pet respond behaviorally to visitors in the home?*

Social, enjoys petting

Initially excited, jumps on

Shy, avoids

Overly excited, becomes mouthy

Barks at doorbell or knocking at the door

Barks at visitors inside the home

Fearful, hides or cowers

Starts out unsure, then warms up

Growls at visitors in the home

Lunges at visitors inside the home

Growls/barks/lunges when visitors go near a family member

Snaps at (no contact)

Bites (contact made)

N/A, did not meet visitors in the home

Other

Other behaviors around visitors in the home:*

Please elaborate on this pet's behaviors around visitors in the home.

Has this pet been housed with dogs?*

Yes

Describe the dog(s) your pet has been housed with:*

Select all that apply

Small dog(s) 1-25 pounds

Medium dog(s) 26-45 pounds

Large dog(s) over 45 pounds

Female dog(s)

Male dog(s)

Puppy (0-6 months)

Young Adult (7-24 months)

Adult (3-9 years)

Senior (10+ years)

Which best describes your pet's behavior with dogs in the home?*

Select all that apply

Always friendly

Indifferent, ignores dogs

Mostly friendly, occasional scuffles

Plays well

Plays too rough

Fearful

Guards items/food/spaces/people

Picks on/bullies dogs

Gets bullied by dogs

Does not get along with, fights often

Other

Other:

Has this pet been housed with cats?*

Yes

Which best describes your pet's behavior with cats in the home?*

Select all that apply

Always friendly

Indifferent, ignores dogs

Mostly friendly, occasionally chases

Plays well

Plays too rough

Fearful

Guards items/food/spaces/people

Seeks out as prey

Does not get along with, fights often

Other

Other:

Has this pet been housed with other types of animals?*

Yes

Please describe their behavior around these animals:

Has this pet been interacted with livestock?*

i.e. chickens/poultry, cows, goats, etc.

Yes

Please describe their behavior around these animals:

OUT AND ABOUT

Help us learn more about this dog's behavior when outside of the home.

How does this dog walk on a leash?*

Walks calmly, no pulling

Pulls occasionally, but mostly does well

Pulls constantly

Difficult to walk

Bites at / mouths leash

Afraid of leash

Does not / cannot walk on leash

Easily startled by loud noises

Pulls excitedly towards people

Pulls excited towards dogs

Reacts negatively to people or other animals on leash

Unsure, have not walked on leash

Other

Other:

How does this dog react to people/other animals while on walks?*

Barks at most people

Growls at most people

Lunges at most people

Barks only at certain people

Growls only at certain people

Lunges only at certain people

Barks at runners/bikers

Growls at runners/bikers

Lunges at runners/bikers

Barks at other dogs

Growls at other dogs

Lunges at other dogs

Barks, growls, or lunges at cats

Has no reaction to any of the above

Other

Other:

How does this dog respond to meeting new people outside of the home?*

Friendly, social

Overly excited - jumps up/pesters for attention

Starts out unsure but then warms up

Indifferent, ignores

Shy, avoidant

Fearful, cowers

Barks

Growls

Lunges

Shows teeth as a warning

Snaps at (no contact made)

Only reacts negatively when on leash

Unsure, has not met people outside of the home

Other

Other:

How does this dog respond to meeting other dogs outside of the home?*

Friendly, greets appropriately

Very excited, eager to play

Comes on strong, but has good intentions

Enjoys play dates with other dogs

Enjoys dog parks

Indifferent, ignores

Shy, avoidant

Fearful, cowers

Barks

Growls

Lunges

Shows teeth as a warning

Snaps at (no contact made)

Only reacts negatively while on leash

Only reacts negatively when there is a barrier (i.e. fence, window, etc.)

Gets along with certain dogs but not all

Unsure, has not met other dogs outside of the home

Other

Other:

Veterinary Information and Medical History:

Veterinarian(s) Information:

Please list all veterinarians (if applicable) that have seen this pet. Use the

to add more information.

Veterinarian or Clinic Name

Phone Number

Which vaccinations have been given to this pet?

DHPP / DHLPP

Bordetella

Rabies

DHPP / DHLPP Details:

Veterinarian or Clinic Name

Date of Vaccination

Bordetella Details:

Veterinarian or Clinic Name

Date of Vaccination

Rabies Vaccine Details:

Veterinarian or Clinic Name

Date of Vaccination

Which vaccinations have been given to this pet?

FVRCP

Feline Leukemia Vaccine

Rabies

FVRCP Details:

Veterinarian or Clinic

Date of Vaccination

Feline Leukemia Vaccine Details:

Veterinarian or Clinic Name

Date of Vaccination

Rabies Vaccine Details:

Veterinarian or Clinic Name

Date of Vaccination

Has this dog had a Heartworm test?*

Heartworm Test Details:

Veterinarian or Clinic Name

Date of Heartworm Test

What was the result of the Heartworm Test?

Has this cat had a Feline Leukemia (FeLV) test?*

Feline Leukemia Test Details:

Veterinarian or Clinic Name

Date of FeLV Test

What was the result of the Feline Leukemia Test?

Has this cat had a Feline Immunodeficiency Virus (FIV) test?*

Feline Immunodeficiency Virus (FIV) Test Details:

Veterinarian or Clinic Name

Date of FIV Test

What was the result of the FIV Test?

Has this pet been spayed or neutered?*

Has this cat been declawed?*

Does this pet have any current or previous special or medical issues?

Medications, special diet, allergies, previous injuries, etc.

Behavior and Personality:

Please provide honest and detailed information. These answers provide us with important information that will allow us to find appropriate homes and are not necessarily used to determine eligibility.

What is this dog's personality like in general?*

Please include energy level, quirks, likes and dislikes, anxiety or fear issues, etc.

Which best describes this cat's personality?*

Please check all that apply.

Social Butterfly

Independent Loner

Ultra Confident

Grumpy Pants

Scaredy Cat

Wild and Mean

Additional personality details:

Please include energy level, quirks, likes and dislikes, anxiety or fear issues, etc.

This dog does NOT do well with:*

Cats

Any Dogs

Certain Dogs

Any Children ( < 12 y.o.)

Certain Children

Certain People

Livestock

Unsure

N/A. This dog gets along with everything.

This cat does NOT do well with:*

All Cats

Certain Cats

All Dogs

Certain Dogs

Unsure

N/A. This cat gets along with everything.

Please provide additional details about the dog's behavior with cats:

Please provide additional details about the dog's behavior with other dogs:

Please provide additional details about the types of dogs your dog does not do well with and their behavior toward them:

Please provide additional details about the dog's behavior around children:

Please provide additional details about the types of children this dog does not do well with and the behavior toward them:

Please provide additional details about the types of people this dog does not do well with and the behavior towards them:

Please provide additional details about the types of livestock this dog does not do well with and the behavior towards them:

Please provide additional details about this cat's behavior around other cats:

Please provide additional details about types of cats this cat does not do well with and their behavior toward them:

Please provide additional details about this cat's behavior around dogs:

Please provide additional details about types of dogs this cat does not do well with and their behavior toward them:

Perks: This is just for extra information and bears no weight in the intake process. Please check all that apply:

Perks:

This is just for extra information and bears no weight in the intake process. Please check all that apply:

Potty Trained

Knows Commands

Gentle on Leash

Crate Trained

Other

Which commands?

Other Perks:

In the event this dog is deemed medically or behaviorally unsound, and thus, unsuitable for adoption, PAWS Shelter of Central Texas, at their discretion, may allow this dog to be reclaimed by the surrendering owner. Would you like to be notified for the opportunity to reclaim this dog under these circumstances?

Yes

PAWS SHELTER OF CENTRAL TEXAS is a non-profit, No Kill shelter and runs entirely on donations to care for its animals. A $55 minimum donation is required for owner surrenders.

By submitting this form, I am stating that all above information contained in this form is complete and true and understand that I have begun the process of relinquishing ownership of this/these animals to PAWS Shelter of Central Texas.

I also understand that PAWS Shelter of Central Texas requires a behavior evaluation for each pet before completing the surrender process and by no means guarantees that this/these animals will be accepted into their adoption program upon completion.