OWNER SURRENDER FORM

OWNER SURRENDER

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.

This form can be used for multiple pets. Please fill out each section individually then select "yes" when asked if you have another pet to surrender. Maximum of 3 pets per form.

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.
Date*
Date Format: MM slash DD slash YYYY
Name*
First Last
Address*
Physical addresses only.

Street Address City State ZIP Code
Phone*
Email*
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.
Species:*
Please choose one.
Pet's Name
Pet's Age*
Please approximate if you are unsure.
Gender*
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.)
Color:*
Please be descriptive.
Coat Length*
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.***
This pet has been kept:*
- Mostly Indoors
- Mostly Outdoors
- Both - 50/50
Upload a photo of your pet, if available.
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:
- Potty Trained
- Knows Commands
- Gentle on Leash
- Crate Trained
- Other
Which commands?
Other Perks:
Do you have another pet to surrender?
SECOND PET
Species:*
Please choose one.
Pet's Name
Pet's Age*
Please approximate if you are unsure.
Gender*
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.)
Color:*
Please be descriptive.
Coat Length*
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.***
This pet has been kept:*
- Mostly Indoors
- Mostly Outdoors
- Both - 50/50
Upload a photo of your pet, if available.
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 Name 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 the cat's behavior around other cats:
Please provide additional details about the types of cats this cat does not do well with and the behavior towards them:
Please provide additional details about the cat's behavior around dogs:
Please provide additional details about the types of dogs this cat does not do well with and the behavior towards them:
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:
Do you have another pet to surrender?
THIRD PET
Species:*
Pet's Name
Pet's Age*
Please approximate if you are unsure.
Gender*
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.)
Color:*
Please be descriptive.
Coat Length*
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.***
This pet has been kept:*
- Mostly Indoors
- Mostly Outdoors
- Both - 50/50
Upload a photo of your pet, if available.
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 Name 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 the cat's behavior with cats:
Please provide additional details about the types of cats this cat does not do well with and the behavior towards them:
Please provide additional details about the cat's behavior around dogs:
Please provide additional details about the types of dogs this cat does not do well with and the behavior towards them:
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:
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.

OWNER SURRENDER FORM

OWNER SURRENDER

SECOND PET

THIRD PET

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