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BARK Rescue Surrender Form
Use this form to provide information relative to the surrender of a dog to our rescue organization. This form can be used for both stray dogs and dogs where the owner is no longer able to take care of the dog.
Your Information
Use this section of the form to provide information about the individual(s) surrendering the dog or bringing a stray to our organization.
*
Indicates required field
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Dog Information
Use this section to provide information about the dog.
Dog's Name
*
Breed
*
Estimated Age
*
0-2
2-5
5-10
10+
Sex
*
Male
Female
Spayed
*
Spayed
Neutered
Unknown
Where did you find this dog?
*
How long have you had this dog?
*
Personality
Use this section to provide information about the personality of the dog.
Has the dog ever bitten anyone?
*
Yes
No
Unknown
How long ago did the dog bite someone?
*
N/A
One Week
One Month
Year or More
Is the dog good with children?
*
Yes
No
Unknown
Is the dog good with cats?
*
Yes
No
Unknown
How does the dog respond to other dogs
*
Has the dog ever injured or killed another animal?
*
Yes
No
Unknown
If , "Yes", please explain
*
Was the dog in a fenced yard?
*
Yes
No
Unknown
Was the dog kept on a chain?
*
Yes
No
Unknown
Health Information
Use this section to share any known health information.
Does the dog have any known health issues?
*
Yes
No
Unknown
If the dog has health issues, please explain.
*
Is the dog "House Broken"?
*
Yes
No
Unknown
Please understand that you completely give up the ownership and all rights to this animal when you surrender it to BARK. Once the animal is surrendered, BARK will decide if it can place the animal up for adoption or into foster care. All animals surrendered to BARK will be examined and determine health and placement of animal until suitable for adoption.
THERE IS NO FEE FOR SURRENDERING AN ANIMAL
Certification
Name
*
First
Last
Pet's Name
*
Today's Date
*
Picture of Your Dog
*
Max file size: 20MB
By submitting this form, you certify the information in this are true and correct to the best of your knowledge. You further certify you understand the terms of this Surrender Form.
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Home
About
Meet the Dogs
See Our Video
Mission Statement
Meet Our Special Partners
Meet our Bark leaders
Donate
Join
Sponsor
Volunteer
Events
Get Gala Tickets Here!
Be a Gala Sponsor
>
Gala
Forms
Intake Submission
Adoption
Foster
Surrender
Personal Pet Release
Volunteer
Volunteer Release Form
Donations
Membership
Mailing List
Contact
Directions
Success Stories
News
Resources
Support Us
Success Stories