Dog Surrender Note: This form is most successful when completed from a desktop or laptop computer. Form submission may fail if you complete from a mobile device. You will receive an email confirmation that your form has been completed successfully. PLEASE NOTE: If this is a not a SAAP dog, you will receive an automated response to confirm that we received the form. Beyond that you will only be contacted if we are able to take the dog into our rescue. If this is a SAAP dog, we will contact you with information on where & when to return.Dogs name? If anyBreed (Best guess if unknown)GenderMaleFemaleAge of Dog (Best Guess if unknown)Approximate Weight of Dog (Best guess if unknown)Why do you have to surrender?Did you get the dog from SAAP? (if NO continue with this form. if YES we will take it back, just continue to fill out the form and email us back in a few days if you have not heard any return instructions)YesNoIf the dog was adopted from SAAP, what was the dog's original SAAP name (if known)?Where did you get the dog? County found if strayHow long have you had the dog?Is your dog spayed/neutered?YesNoIs your dog current on shots?YesNoIs your dog current on heartworm prevention?YesNoIf yes can you provide proof?Are you willing or able to foster until a home or alternate foster can be found?YesNoIs the dog good with kids?* Yes No Please explain.*Is the dog good with cats?* Yes No Please explain.*Is the dog good with other dogs?* Yes No Please explain.*Are there any known behavior problems?Have you experienced any aggression with the dog?*YesNoIs the aggression towards humans, other dogs, or both?*HumanDogsBothIf there have been any actual bites, have any been reported to any authority? If so, who and when?*Approximately how many bites have occurred and please give a little information surrounding the circumstances of those bites, including severity:*Have you attempted any training interventions, if so, what type? If a trainer was used please provide trainer's name:*Have you contacted your vet to rule out a pain or possible thyroid issue? If so, please explain including any results.*If children have been bitten or otherwise shown aggression, what are the ages of the children?If children have been bitten, or otherwise been shown aggression, how often are they left unsupervised with the dog?Did the aggression start completely out of the blue?*Were any "resources" (i.e., bone, food, toy, bed, human) involved that were being guarded?*Did the dog give any warning, or show any other signs of being uncomfortable (i.e., growl, ears back, whites of the eyes showing, trying to get away from the situation)?*Please provide us with any additional information that would be helpful for us to know, in as much detail as possible:Aggression is shown (check all that apply): On leash At the dog park In your yard/home When toys are out When bones are out When food is out When in crate Does your dog identify specific dogs that it does not like, i.e.: large, male dogs?*Is your dog allowed on furniture?*How much exercise does your dog get daily (unsupervised yard time does not count)?*Was your dog okay with other dogs until a specific event? If so, please describe, in as much detail, the event.Did the dog give any warning, or show any other signs of being uncomfortable (i.e., growl, ears back, whites of the eyes showing, trying to get away from the situation)?What have you tried to do to correct or control the behavior?*Please provide us with any additional information that would be helpful for us to know:Are there any known medical problems?Is the dog crate trained?YesNoIs the dog housebroken?YesNoWhat food are they currently eating?Other Information or comments:Name First Last AddressCityStateZipcodePhoneCellAlternate PhoneEmail Enter Email Confirm Email Dog Photos (multiple photo upload) Drop files here or This iframe contains the logic required to handle Ajax powered Gravity Forms.