Owner Surrender Request

Owner Information:

Dog Information:

Sex: *
Spayed or Neutered: *
Ears: *
Tail: *
Has your dog been Heartworm tested recently? *
Results: *
Is this dog currently on Heartworm preventative? *
If your dog is not up to date on vaccinations, heartworm preventative, spayed or neutered or is heartworm positive, are you willing to make a donation to cover the costs of these procedures or willing to have them done before surrendering your dog? *
Has your dog ever bitten anyone? *
Attempted (snapped, growled, etc.) *

Please tell us a bit more about your dog: Is this dog good with:

Check all that apply:
Where does your dog live now? *

Finally, I understand that I will be required to turn over any AKC/CKC registration paperwork, all veterinary records and sign an owner surrender form giving all ownership rights to Gulf Coast Doberman Rescue.

Furthermore, I understand that GCDR makes no guarantees as to placement of my Doberman.

Agree to surrender: *
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