Name
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First Name
Last Name
Email
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Phone
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(###)
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####
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Pet's name
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Species
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Gender
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Please check all that apply
Age
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Colors/markings
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Please explain why you need to surrender your pet.
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Where did you get him/her?
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How long have you had him/her?
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Has your pet ever been to the veterinarian?
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Please check all that apply
Date of last vet visit
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Please indicate if you've noticed any diarrhea or breathing issues
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Check all that apply
Where did (s)he live?
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What type and size of housing did your pet have?
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What type of bedding was used?
Does (s)he ever get possessive of his/her space?
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How often does your pet spend time out of his/her cage?
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How often is your pet handled by people?
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Describe his/her personality. Please be specific - these details will help them get adopted.
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Has he/she ever bitten anyone? If YES, please describe the circumstances.
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Describe any other behavioral issues
Please list any of your pet's favorite toys/activities
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Has (s)he lived with children? If so, please list their ages.
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Has (s)he ever interacted with other animals?
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If you answered yes to the previous question, please list which species/how many/breeds/sexes, and describe how they interacted with each other.
What type of food is (s)he used to eating?
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What types of vegetables, treats, or other supplements is (s)he used to eating?
Rabbit/Ferret: is your pet spayed or neutered?
Ferrets: Date of last rabies vaccination
Rabbit/Ferret: does your pet wear a harness?
Rabbit/Ferret: Does your pet use a litter box?
Our suggested surrender fee is $200 per dog/puppy, $100 per cat/kitten, and $50 per small animal. On average, the expense per pet that APCSM incurs is about $60 per day. If these fees are beyond your means, we kindly request that you contribute whatever sum you can comfortably manage. Regardless of your financial capacity, we are committed to helping your pet and we will still provide care for your animal. The APCSM receives no state or federal funding and relies solely on community support and donations. Please indicate what you can give:
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