First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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County

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

PLEASE NOTE: Our training team will be in touch to set up a temperament test to evaluate if the dog is a good fit for any of our foster homes. Temperament tests happen in South Minneapolis. Owners must be willing to drive to meet our volunteer at this location.

Name

What is the name of the animal?*

What is the breed of the dog? *

What is the age and approximate birth date of the animal you wish to surrender?*

What is the estimated weight? (dogs only)

Was this animal previously adopted from Wags? *

Please provide the reason you are needing to surrender this animal.*

Is the animal you wish to surrender spayed/neutered?*

Do you have vet records showing a current rabies and distemper vaccine?

Veterinarian's name and phone number. Please note, we will be calling to verify the vetting status of your resident animals. Many vets require verbal authorization from you to release information to us so please be sure to do that do avoid any delay in processing your application.*

Is the animal microchipped?

If yes, what is the microchip vendor and number?

Does your animal need to be the only pet in the household? *
Choose one: Yes No

How is your dog on a leash around people and other dogs? *do they pull *do they lunge at other dogs/people *do they jump on people *do they bark*

What are your dogs best attributes? *

Is your dog house trained?

Is your dog crate trained?

How long has this dog been in your care? *

What is the energy level of your dog? *

Does the animal you wish to surrender have any health issues? If yes, please describe. *

Describe how the animal you wish to surrender reacts to older and younger children. *

Describe how the animal you want to surrender acts towards cats. *

Describe how the animal reacts to male dogs and female dogs. *

Has the animal you wish to surrender ever shown any aggression (nipping, snapping, growling, etc.) towards people, children, or other animals? If yes, please describe:*

Has the animal you wish to surrender ever bitten an animal or person? If yes, please describe:*

Has the animal you wish to surrender been declared Dangerous or Potentially Dangerous? *

If your animal has been declared Dangerous or Potentially Dangerous, what City and/or County made the declaration?

If your animal was declared Dangerous or Potentially Dangerous, on what date was the designation made?

I consent to have my animal submitted to temperament testing by Wags & Whiskers Animal Rescue of Minnesota. I understand that acceptance of my animal is dependent on temperament testing. *

A $50 owner surrender fee is required. Do you agree to pay this fee if your animal is accepted into Wags & Whiskers Animal Rescue? Wags & Whiskers reserves the right to reject any and all surrenders for failure to pay required fee.

I certify I am the legal owner of the animal stated above.

I certify that the information provided in this form is true and correct to the best of my knowledge. *

I understand the submission of this application does not guarantee Wags & Whiskers Animal Rescue will accept my animal. I understand that there is a waiting list to surrender animals that ranges from 1-4 weeks.