Surrender Form

Please fill out this important form if you wish to surrender your animal to Animatch.

Name * First Last
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Your Email address
Home Phone # * - (###) - ### ####
Cell Phone or Work Phone # - (###) - ### ####
Animal Information
Name of Animal *
Type of Animal * Dog Cat Other
Sex of Animal * Male Female
Animal's Date of Birth (if unknown, approximate age) *
Description/Breed/Mix *

Enter the animal description, breed or mix.
Where did you get this animal from? * Family/Friend Breeder Found Classified/Newspaper Berger Blanc SPCA Montreal SPCA Laval Pet Store Other
Reason for surrender *
Name of Veterinarian
Veterinarian phone # - (###) - ### ####
Veterinarian address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Where did you hear of Animatch?
Animal Medical History

Is this animal...
Vaccinated? * Yes No
Can you provide us with the vaccination certificate? * Yes No
Sterilized? * Yes No
Declawed? * Yes No Not applicable
Dewormed? * Yes No Not Applicable
Does your pet have any allergies? * Yes No Don't know
Animal's Environment

Is this animal...
An outside dog? * Lives outside Lives inside
House trained? * Yes No
Cage trained? * Yes No
Paper trained? * Yes No
Litter trained? * Yes No
Leash trained? * Yes No
Does your pet suffer from or show signs of separation anxiety? * Yes No
If so, please describe
Animal History

Does this animal...
Bark? * Yes No
Bite? * Yes No
Chew * Yes No
Scratch? Yes No
Dig? * Yes No
Escape? * Yes No
Jump on furniture? * Yes No
Jump over or crawl under fences * Yes No
Good Behavior

Does this dog...
Behave in the car? Yes No
Behave with children? * Yes No
Behave with other animals? * Yes No
Behave with people in general? * Yes No
Was this your first dog? * Yes No
Food
Food Brand *
Type of food * Canned Dry Semi-moist
Does this dog have food allergies? If yes what are they?
Did this dog receive any kind of training? * Yes No
If yes, what kind? Obedience Agility Rescue Attack Other
Household Story
Is he/she left alone? * Yes No
If yes, for how long?
Where is the best place to keep him when he's left alone ? *
Where does he sleep at night? *
Lives with other dogs? * Yes No
If yes, any reaction with other dogs?
Any children in household? Yes No
If children, what age?
Reaction with children?
Is the animal rough? * Yes No Sometimes
Is the animal mouthy? * Yes No
Activities & hobbies
Favorite game to play?
Do you have a yard? * Yes No
Is your yard fenced? * Yes No
Does it fetch? * Yes No
Does it go off leash? * Yes No
Does it get waked? * Yes No
Does he wander off? * Yes No
Does it entertain himself? Yes No
Will he come when you call him? * Yes No
Does he ever meet new dogs on his walk? * Yes No
If yes, what is the reaction? *
Do you let him sniff/touch/play? * Yes No
If family is eating a meal, where would this dog be? *
If you are in a living room watching tv, where would this dog be? *
Habits with visitors & habits about himself
When guests /visitors/Purolator or service people come to the door, where is dog kept? * Outside Cage Room Free Held by collar or leash
How long does it take him to calm down when someone comes to the house? *
Has this animal ever nipped at you or someone in family or entourage? * Yes No
What is/has been this animal's response when you try to go near your dog while he's eating or chewing on a bone? *
Helpful information
What are his best qualities? *
What are his worst habits? *
Who does the dog listen to best in the household? *
Why? *
How is this dog best disciplined? *
What kind of naughty things does he do that you've needed to discipline him for? *
If you could change one of his bad habits, what would it be? *
What commands would be helpful to teach this dog before he goes to another home? *
What are some of the cutest & nicest things about this dog? *
Does this animal have any previous notable medical history * Yes No
If yes please give details or submit Vet report
If this animal is considered unadoptable by Animatch, are you willing to take him back ? * Yes No
If we do contact you for this, are you are willing & able to take the animal back within 48 hours? * Yes No
The surrender fee is non- refundable. Has this animal been outside of Canada prior to this surrender? * Yes No
If yes please explain
Is this animal tattooed / micro chipped or otherwise identifiable? * Yes No
If yes, please provide details
Is there anything else that you would like to declare about this animal at this time of surrender? * Yes No
If yes, please provide details
Are you the main companion to this animal? * Yes No
To the best of your knowledge, is there anyone else that may lay a claim as guardian or companion to this animal? * Yes No
If yes, please provide details
Terms & conditions * I certify that this animal is in good health and has no severe behavioral problems. If the animal is proven non adoptable due to health or behavioral problems, these problems will be discussed between Animatch and our veterinarian and a decision will be made as how to proceed with the problem. Please note that euthanasia might be the only option, despite our no kill policy.
Type the letters you see in the image below.

Surrender Form

Surrender Form

Animal Information

Animal Medical History

Animal's Environment

Animal History

Good Behavior

Food

Household Story

Activities & hobbies

Habits with visitors & habits about himself

Helpful information