Dog Surrender Application Form Start the Surrendering Process Today

We want to make sure that we have the best fit for our foster and furever homes and rescue dogs, filling out the form below will help us match the rescue dog with a family’s lifestyle and what they are looking for in a pet.

Please check out our Dog Surrender Application Process page for detailed information on our process and eligibility before filling out the form.

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To note, we respect your privacy and do not tolerate spam. We will never sell or give away your information (name, address, email, etc.) to any third party. All information on this form is kept confidential between our directors and volunteers. We may discuss pet history with your veterinary hospital if applicable.

The Surrendering Family Contact Information

Please enter your first name.
Please enter your last name.
Please enter your phone number.
Please let us know what type of phone number you've entered.
Please let us know the best time to call the phone number provided.
Please let us know if there is another phone number to reach you at.
Please enter your alternate phone number.
Please let us know what type of alternate phone number you've entered.
Please let us know the best time to call the alternate phone number provided.
What’s your Home Address?
Please enter your street number and name,
Please enter your city.
Please enter your province.
Please enter your postal code.
Please let us know if you have a spouse/partner.
Please enter your spouse/partner's first name.
Please enter your spouse/partner's last name.

About the Dog Being Surrendered

Please let us know why you have chosen to surrender your pet.
Please let us know from where/who did you got the dog, including the breeder's contact info if applicable.
Please let us know how long you have owned the dog.
Please let us know the dog's name.
Please let us know the dog's date of birth or its age.
Please let us know the dog's breed.
Please let us know your gender preference.
Please let us know if the dog has been spayed/neutered.
Please let us know where the dog is used to sleep at night.
Please let us know where the dog is used to be kept when you leave the house.
Please let us know is the dog is housebroken.
Please let us know if the dog is crate trained.
Please let us know if the dog is destructive when left alone.
Please let us know what the dog does when left alone.
Please describe what other behaviour the dog does when left alone.
Please let us know how was the dog left outside.
Please let us know how the dog was left outside.
Please let us know how the dog behaved when left outside.
Please let us know how the dog behaved when left outside.
Please let us know if the dog has been consistently around children.
Please let us know the children's age(s) the dog is used to be around.
Please let us know if the dog is rough or gentle when playing with kids, please describe a usual interaction.
Please let us know if the dog’s experiences with children always been positive.
Please let us know how the dog's experiences with children is not always positive,
Please let us know if the some has ever bit someone.
Please provide the fence requested details.
Please let us know if the dog has ever lived with cats.
Please let us know if the dog likes cats.
Please let us know if the dog has ever hurt a cat.
Please describe the situation when the hurt a cat.
Please let us know if the dog is the only one in the household.
Please list the other dogs in the household.
Please let us know if the dog gets along with other dogs.
Please let us know if the dog has ever been in a dog fight in which either dog was injured.
Please explain the situation when the dog fight with injuries occurred.
Please let us know what is the dog’s reaction when new visitors enter the house.
Please let us know what is the dog’s reaction when you take a favorite item from them.
Please let us know what is the dog’s reaction when you take a food from them.
Please let us know what is the dog’s reaction when you disturb them from sleep in their favorite spot.
Please let us know what is the dog's usual behaviour.
Please let us know what type of people the dog feel most comfortable with.
Please let us know what the dog is scared of.
Please let us know what else scares the dog.
Please let us know if the dog will let you groom it.
Please let us know if the dog will let you clip its nails.
Please let us know if the dog has behavioral problems.
Please describe/explain the dogs behavioural problems
Please let us know what are two(2) things you like most about the dog's behaviour.
Please let us know what are two(2) things you dislike most about the dog's behaviour.
Please let us know if all family members are aware that the dog is being surrendered.
Please explain the situation with the household and awareness of the dog being surrendered.
Please let us know what would have to happen for you to keep the dog.
Please confirm that you accept the mandatory surrender fee.

Health & Veterinary Reference

Please let us know if the dog has any medical problems.
Please describe the dog's medical problem(s).
Please let us know if the dog takes any medications.
Please describe the medications the dog takes.
Please let us know when was the dog's last vaccination & rabies shot.
Which Veterinary Clinic looks/looked after of your current or past pets?
Please let us know the name of the veterinary clinic's that looks/looked after of your current or past pets.
Please let us know the phone number of the veterinary clinic's that looks/looked after of your current or past pets.
Please let us know the name of the veterinarian at the clinic's that looks/looked after of your current or past pets.
Please confirm that you will be calling your vet to give permission.

By submitting this application, you confirm that the information provided on this form is true and correct. You further understand that by providing this information, Fulfilling Hearts Rescue is under no obligation to accept your dog.

You understand that you will no longer have ownership rights whatsoever to the above named dog once under Fulfilling Hearts Rescue’s care.

In addition, you understand that said dog will be rehomed to an appropriate family based on the rescue group’s best judgment. You do not have any say or objection towards where the above mentioned dog will end up. You also agree that you are not to attempt to contact the dog’s new adoptive family without permission from the directors of Fulfilling Hearts Rescue. You understand that appropriate legal measures may be taken to protect the new adoptive family if necessary.

Finally, you have hereby decided to surrender complete care and control of your dog listed above to Fulfilling Hearts Rescue

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We have everything from clothing to coffee mugs sporting our logo with all proceeds going to our rescue dogs in need!

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