Re-Homing Request

Questions marked by * are required.
1. Name: *
2. Address: *
3. Phone: *
4. Email: *
5. Name of dog: *
6. Breed of dog: *
7. Sex of dog: *
  • M
  • F
8. Spayed/Neutered *
  • Yes
  • No
9. Is the dog up to date on shots? *
  • Yes
  • No
10. Does the dog have any significate health problems? *
  • Yes
  • No
11. If yes, please explain:
12. Please describe the dogs temperament: *
13. Is the dog currently (or will be) chained or penned? *
  • Yes
  • No
14. Please upload a photo of your dog. *
15. I agree to give Dogs Deserve Better access to medical records for this dog. *
  • Yes
  • No
16. Name and Phone Number of your Veterinarian: *
17. In return for this service, I agree to not chain or pen any more dogs outside and give Dogs Deserve Better my permission to take any dogs chained or penned on my property. *
  • Yes
  • No
18. I represent and warrant that I am the lawful owner of the Animal(s), and I have full power and authority to surrender the Animal(s). No other person has any legal or equitable ownership interest in the Animal(s). I further acknowledge that I am releasing the Animal(s) completely voluntarily and that no representations, considerations or promises of any kind have been made to me by DDB or any of its representatives. I understand that by releasing the Animal(s) to DDB, I relinquish all ownership or other interest in the Animal(s). I will not chain/pen another dog on my property or in its place. I will not seek further information about the Animal(s) and will not press DDB for details. My contact with the Animal(s) terminates at the time of surrender is under no obligation whatsoever to follow up with information about the Animal(s). I hereby release and forever discharge DDB from any and all rights, claims, obligations, liabilities, and causes of action whatsoever arising out of or relating to the ownership, possession, or disposition of the Animal(s), and I agree to indemnify and hold harmless DDB from and against any and all such rights, claims, obligations, liabilities, and causes of action which may be asserted by third parties. This is a legally binding document for the irrevocable surrender of your Animal(s) to DDB. I have fully read and understand this Surrender Agreement. I accept and agree to abide by its terms. By typing your name you agree to the terms of this contract. *