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

Please complete the surrender form below. If you wish to download a paper copy and send it to us instead, you can do so  here.


Organization Seeking to Transfer a Senior Dog?
Please contact our Program Coordinator for more information or 612-276-2334

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 TrainedRides 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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