Distinguished Dobermans Rescue, Inc. Owner Surrender Form

Your Contact Information

First Name: *

Last Name: *

E-mail Address: *

Confirm E-mail Address: *

Phone Number: *

Street Address: *

City: *

State: *

Zip Code: *

Name of Dog: *

Sex of Dog: *

Male

Female

Approximate Age of Dog: *

When did you acquire this dog (month & year)? *

0/50 words

Where did you acquire this dog? *

0/50 words

Can you provide a photo of this dog? *

Yes

Please upload a picture(s):

What date does this dog need to come into rescue? * +

Why is this dog being released to rescue? *

0/150 words

Will you be able to transport this dog to us? *

Yes

Maybe