Small Animal Surrender Questionnaire : Surrendering : Resources : Ramapo-Bergen Animal Refuge, Inc.

Thank you for your surrender inquiry. We know the decision to surrender is difficult, and hope we can provide you with further options and ways we can help. Please note that submitting this form does not guarantee that we will be able to take your small animal, and is solely a way for our staff to learn your animals needs and how we can further help you and your pet. Please know we are only able to communicate with the legal owner of the pet.

We hope that you have exhausted all options before considering surrendering (training, family, finding a residence that allows pets, allergy tests). Please understand that surrendering a pet is final and you will not be able to take your pet back. Because we are a non-profit organization, you may be asked to leave a donation to help with their care, but please feel free to let us know if this is a concern. We can only accept animals as space becomes available.

Please answer ALL questions fully and to the best of your ability. We ask that you also upload and provide us with a photo of your animal for reference.

Owner Information

Name

First Name *

Last Name *

Age

Email Address

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Phone Number

Animal Information

Pet/Pets Name

Age of Pet

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Gender of Pet

Breed/Type:

Size

How would you describe your pet? (outgoing, friendly, shy, fearful, etc.)

Is your pet afraid of anything?

When your pet is left alone, do they have separation anxiety, chew, or become destructive?

How many hours does your pet spend home alone?

Where does your pet stay at night or when alone?

Is your animal protective or possessive of anything? (food, toys, family, etc.)

How does the animal behave around strangers? (friendly, afraid, mouthy, bolts, etc.)

Does the animal get along with other animals?

Surrender Information

Why are you surrendering this animal?

In what time frame are you needing to surrender your pet?

If you are giving up the pet for behavioral problems, what have you tried to correct the problem?

If you are surrendering because you need to move into an apartment, did you know that there is pet friendly housing available or certification if your pet is an emotional support animal?

(please inquire at adoptlove@rbari.org for more information)

Has your pet ever bitten anyone?

How long have you had this pet?

Where did you get this pet? (Rescue, friend, family, etc.)

What ages and types of people did your pet live with? (Men, Women, children, etc.)

How would you describe your household? (Active, noisy, quiet, calm, etc.)

Medical History

Have you ever taken your animal to the vet?

If so, where did you take your pet to the vet?

Does your pet have a medical condition or are they on any medications?

*We ask that you provide us with any relevant medical history and records*

Further Information

Is there any other information about your pet that we should know?

Please upload animal photo(s)

No file selected

Click or drag here to add files

Ramapo-Bergen Animal Refuge (EIN 22-6094179) sincerely thanks our donors & sponsors:

84 Lumber
Allstate
Athletes For Animals
BC The Magazine
Dr Elsey's
The Farmer's Dog
Hackensack Meridian Health

Golf sponsor, leave up til 9/1/17
Home Moving Solutions
Inserra Supermarkets

Golf Sponsor, keep up til 10/1
Jan Fence
PetFinder Foundation

Crafted by Firespring

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