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You are here: Home / Surrender Questionaire

Surrender Questionaire

Please complete the following questionnaire.

Your Name:

Phone Number (home and/or alternate):

E-mail address (Only one email address please):

Type of animal (ie: dog, cat, small animal):

Breed of animal (ie: lab, persian, gerbil):

Your Pet's Name:

Sex of Animal: MaleFemale
Age of Animal:

Is your pet Spayed/Neutered?:
Is your pet current with his/her vaccinations?:
Are there any health concerns with your pet? (ie: medications, skin conditions, chronic ear infections etc..):

Reason for surrender:

Has your pet ever bitten?:
Is your pet good with children?:
If so, what ages?:

Is your pet good with dogs?:
Is your pet good with cats?:
Is your pet good with other animals such as birds, livestock or rodents?:
Is your pet house or litter trained?:
Is your pet crate trained?:
Does your pet attempt to escape?:
Does your pet get car sick?:
Does your pet experience separation anxiety?:
Does your pet have any basic training?:
How would you describe your pet's personality and their needs:

The Northern Alberta Society for Animal Protection is a non-profit organization. We rely on the generosity of donations to maintain the organization and provide for our animals.

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