Surrender Form

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Pawsitively Pugs Rescue understands that the decision to surrender your dog is not an easy one. We are not hear to judge you but to make this as easy as we can for both you and your dog. Please give us as much information as possible about the dog so that we can find the perfect foster home to make the transition as easy as possibly for him/her. If you have questions please feel free to reach out to us at pawsitivelypugsrescue@gmail.com.

Name
First Last
Phone
City
State
Email
Have you made the final decision to surrender the dog?*
- Yes
- No
Dogs Name*
Dogs age*
Gender*
- Male
- Female
Is the dog spayed/neutered?*
- Yes
- No
- Unknown
Is the dog a full blooded pug?*
- Yes
- No
- Unsure
If you answered "no" to the above, please tell us what your pug is mixed with?
Is the dog housebroken?*
- Yes
- No
- Partially
Is the dog crate trained?*
- Yes
- No
- Don't Know
How long have you had the pug?*
Is the dog current on vaccines? If yes, which ones?*
Has the dog been kept on heartworm prevention?*
- Yes
- No
- Don't know
Veterinarian Office Name and Phone Number*
Does your dog have any medical conditions that you are aware of?

Note: We do not turn away dogs that have medical conditions so please be truthful so that we can make sure the dog gets appropriate care for their condition
Is the dog on any medications? If so, which ones?
Does the dog have any allergies that you know of? If so, what are they?
Is the dog good with children?
- Yes
- No
- Don't Know
Is the dog good with other dogs?
- Yes
- No
- Don't Know
Is the dog good with cats?
- Yes
- No
- Don't Know
Has the dog ever bitten anyone?
- Yes
- No
- Don't Know
Why are you surrendering the dog?
Any other information about the dog that you can tell us that will make this transition easier for him/her? Likes/Dislikes?
We will work to take the dog into rescue as quickly as possible. Please tell us how urgently you need to place the dog in rescue. This is just a guide and we cannot guarantee we can accommodate so please be patient and as flexible as possible.*
- Emergency
- 1-2 Weeks
- 2-3 Weeks
- 3-4 Weeks
- 4+ Weeks
If you are able to help at all with transport it might assist us getting the dog into rescue faster. If so, how far are you willing to travel?
How did you hear about Pawsitively Pugs Rescue?
- Internet
- Friend Referral
- Vet Referral
- Event
- Other
By clicking agree I signify that I am the legal owner of this dog and that I understand that once the dog is surrenedered to PPR the dog will not be returned to me for any reason. I also am agreeing that PPR can call the veterinarian and obtain the dogs records. Note: If you can provide copies of the vet records the intake process will move along quicker.*
- Agree
- Disagree

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