Tender Loving Crested Rescue - Release of Ownership

Release of Ownership

Please complete this form in detail

Name of dog *

Age *

Date of Birth

Sex *

Breed *

Color

How long have you had the dog? *

How did you acquire the dog? *

Why are you surrendering the dog to this rescue? *

Your Contact Information

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Drivers License/State

Dog's Medical Information

Vet Office Name *

Vet Office Phone Number *

Microchip Number

Microchip Company

Date of Last Exam

Date of Last Rabies

Date of Last DHPP

Date of Last Bordetella

Date of Last Heartworm Test

Result of Heartworm Test

Heartworm Preventative Given and Schedule

Type of Food Given and Schedule

General Questions

Does the dog have any conditions that requires medical treatment or special care? Is he/she on any medicine? *

Has the dog ever shown any aggression or bitten anyone? If yes, please describe. *

What behavior problems, if any, is the dog displaying? *

Is the dog housebroken? If yes, please list schedule. *

Please list any characteristics a new owner may want to know about the dog. *

Does the dog have any scars or distinguishing features?

Is the dog good with children?

Is the dog good with other pets?

Has the dog had basic obedience training?

Please upload up to three pictures of the dog

File Upload

Click or drag a file to this area to upload.

File Upload

Click or drag a file to this area to upload.

File Upload

Click or drag a file to this area to upload.

Acknowledgement

I understand and agree that I am giving up all rights of possession and ownership of the dog describe above and that I will not be able to redeem this dog at any time, nor will I be allowed to know the dog’s whereabouts or status.

I understand and agree that by submitting this form, the dog described above becomes the sole property of Tender Loving Crested Rescue. I promise that the information I am giving is accurate, and that Tender Loving Crested Rescue will not be held liable for any false information or misrepresentations that I may have submitted on this form. I further understand and agree that Tender Loving Crested Rescue will do whatever is necessary for the safety and well-being of this dog including vet care and rehoming.

I sign this Release of Ownership Agreement truthfully asserting that the dog is mine to release and that I have answered the questions above truthfully.

If you agree to the Release of Ownership terms, please enter your full legal name and today's date.

Full Legal Name *

Today's Date *

Name