Surrender Request — Kritter Krazy Rescue

Owner Surrender Request

By submitting this request, I state I am the legal owner of the animal(s) that is/are the subject of this surrender request. Please fill out one for per animal, unless it is a bonded pair or group.

Name of Animal:

First Name

Last Name

Species:

Age:

Gender (if known):

How long have you owned the animal(s):

What is the current diet, what and how often:

Current or previous health concerns:

Are there any vet records for this animal:

Any additional notes (behavior, favorite food, handling, etc.):

Will the animal(s) come with an enclosure and or supplies? If so, please list so we can be prepared:

Reason for surrender:

Where is/are the animal(s) currently located (City and State):

Are you able to transport the animal(s) to an intake volunteer if needed:

Owner information:

Owner information: Name: Phone Number: Email: Preferred communication: Text, Email, Phone call?