SURRENDER APPLICATION

SDRO rehomes older dogs


This is an APPLICATION to surrender and does NOT constitute an agreement by SDRO to take in your dog. We will let you know if we are able to accept your dog upon receipt of a COMPLETED form.

Please fill out this application to surrender a senior dog (age 6 and up) to Senior Dog Rescue of Oregon (SDRO). While SDRO would love to be able to help all of Oregon's senior dogs, as a 100% volunteer, and 100% donor funded organization, we are limited by available resources.

We know that making the decision to re-home a dog can be difficult. By filling out this application as completely and honestly as possible, you will help us to find the best fit possible, should we be able to help with your dog. After you have submitted your completed application, one of our volunteers will contact you within 2 business days to further discuss the possibility of rehoming your dog.

Note: SDRO is not allowed by law to accept stray or abandoned dogs. If you have found a stray dog, please contact the animal control authority in the county where the dog was found.

* = required fields. All questions need to be answered, even if N/A is the answer.
Dog's Name *
Breed *
About You
Your First Name *
Your Last Name *
Street Address *
City *
State *
Zip Code *
Email Address *
Home Phone (with area code) *
Cell Phone (with area code) *
Work Phone (with area code) *
Preferred contact method (e.g., home phone, email, etc.)? *
Is there a specific date your dog needs to be out of your home? * Yes    No
If yes, please provide date and explanation?
Are you able to foster your dog while we screen potential adopters? * Yes    No
Note: SDRO cannot guarantee placement for your dog.
About Your Senior Dog
Age *
Sex: * Female    Male
Weight *
Spayed/neutered? * Yes    No
If no, please explain:
Microchipped? * Yes    No
If yes, provide chip company and chip number:
Medical Information
Veterinarian's Name *
Veterinarian's Address *
Vet's Phone (with area code) *
Date last seen by vet *
Is your dog up to date on vaccinations? * Yes    No
Does your dog have any current medical issues? * Yes    No
If yes, please explain:
Is your dog currently taking any medications? * Yes    No
If yes, please list:
Home Environment
Where is your dog kept when you are home? *
Where is your dog kept at night? *
Where is your dog kept when home alone? *
How long is your dog typically left alone? *
Does your dog require a fenced yard? * Yes    No
Is your dog good with other dogs? * Yes    No    Unknown
Is your dog good with other cats? * Yes    No    Unknown
Is your dog good with children? * Yes    No    Unknown
If yes, what ages of children:
How would you describe your dog's behavior around children? (check all that apply): * Friendly    Gentle    Nervous
Aggressive    Protective    Excited
Unpredictable    Interactive    Unknown - I've never seen my dog around children
Is there any reason your dog should not live with other dogs, cats or children? * Yes    No   
If yes, please explain:
Training / Behavior
Has your dog had any formal training? * Yes    No
If yes, please explain:
Is your dog house trained? * Yes    No
Is your dog crate trained? * Yes    No
Is your dog leash trained? * Yes    No
What commands does your dog understand? *
Please list some activities your dog enjoys (e.g., walks, playing fetch, snuggling on the couch): *
Please list five words that best describe your dog (e.g., goofy, smart, playful, quiet)?: *
Is your dog protective of.... (check all that apply): * Food    Toys    Family    Property
Other
If Other, please explain:
Is your dog frightened of.... (check all that apply): * Loud noises    Other dogs    Strangers
Vaccuum cleaners    Other
If Other, please explain:
Has your dog ever bitten anyone? * Yes    No
If yes, please explain the circumstances:
Please tell about any other behavior concerns not already listed. *
Has your dog ever had a report filed with animal control? * Yes    No
If yes, please explain:
Reason for Placement
Tell us why you are seeking placement for your dog? Please be honest! It will help us find a suitable home for your dog. *
Please describe the ideal home for your dog. *
May new owners contact you? * Yes    No
Signature *
Date *

Thank you for considering rescue for your senior dog!


Please email us:
  • A copy of your dog's most recent vaccination record
  • 3-5 good photos of your dog
  • Be sure to put your dog's name in the subject line right after it says "Surrender Info" (ex: "Surrender Info for Fido")
 

We cannot process your Surrender Application until it is complete (including up-to-date vaccine records, and photos.)

By submitting this application, I certify that I am the legal owner of the dog I seek to surrender and that all of the information I have provided is true and complete, to the best of my knowledge.


We reserve the right to refuse any applicant. Thank you for taking the time to complete this Surrender Application which helps us to make the best possible placement for all concerned.

 
Have questions? Contact SDROregon@gmail.com.