SURRENDER

Surrender Your Dog To us

Interested in surrendering your dog to us?
Please fill in the application below and click “SUBMIT” and we will be in touch soon after to discuss the next steps.

SURRENDER QUESTIONNAIRE

This form will allow Beulah Land Dog Rescue to assess your pet’s background, personality and needs. 
A time will be scheduled for us to meet your pet should the review of this form determine that is necessary. 
Please note, Beulah Land Dog Rescue will consider Owner Surrendered Dogs only from the Central Pennsylvania area.
 

General Dog Information:

Gender:

MaleFemale

Altered (spayed/neutered):

YesNo

Current on Vaccines :

YesNo

Heartworm Preventative given monthly :

YesNo


Owners Personal Information


Background Information on Dog

Is your dog crate trained?

YesNo


Medical History


Veterinarian Information

Do you give permission for one of our volunteers to contact your vet?

YesNo

Please note a complete medical history needs to be given to Beulah Land Dog Rescue at the time of the Dog surrender.


Temperament

Does your Dog let you trim its nails?

YesNo

Does your Dog let you touch its feet, face and belly?

YesNo

Does your Dog have any formal obedience training?

YesNo


Living Environment


Your Contact Information