Owner Surrender Information

Must be minimum 10 years of age (adjusted by breed)
Must be current on Rabies, Distemper, and kennel cough vaccines.
Must have a current heartworm test and a recent (within 2 weeks) fecal test.
Send completed “Owner Surrender” form along with veterinary records and current photograph(s) of the dog(s) to our Program Coordinator, Beck, at

Please download the owner relinquishment application here.


Organization Senior Dog Transfer
Contact our Program Coordinator for more information: or 952-353-2122

Surrender Form

House dogOutside dogBoth

Please attach copies of all vet records including rabies certificate signed by veterinarian


(Owner’s initials)

Barks/Howls/WhinesDumps TrashDigsJump on peopleMark its territoryRoams

Handles StepsWalk on LeashCrate TrainedRide Well in CarTears Furniture/Carpet

BicyclesCatsChildrenFirecrackersLoud noisesMotor VehiclesPassing carsReact to UniformsStormsStrangersVacuums

ActiveAggressiveDestructiveEasy GoingFriendlyNervousNeuroticReservedShyStubbornNoisyObedientOne Person dogPlayfulProtectiveQuiet

Baby to 5 yrs5-910-13Older




FriendPet ShopGiftStrayBreederAnimal ShelterAbandonedOther


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