Miniature Schnauzer Rescue of Houston

The attached form is used to surrender a Schnauzer (and Schnauzers only) that you own to MSRH.  There is a separate form for surrendering stray Schnauzers that you may have found and rescued.  You may complete this form but must understand that MSRH is not obligated to take a dog surrendered by an owner simply because a form has been completed.  You will be contacted directly regarding MSRH’s ability to assist.

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Before We Get Started

1. The person submitting this form is the legal owner and herby releases the custody of the Miniature Schnauzer named below to Miniature Schnauzer Rescue of Houston (MSRH) for the purpose of placement into an adoptive home with the following conditions: 1) The dog will not be destroyed except in the case of terminal or disabling mental or physical illness, or a member of the rescue committee deems the dog/bitch unplaceable; 2) The person submitting this form may recover the dog only if the dog has not been placed in another home and only by complying with the normal MSRH adoption procedures; 3) All claims to this dog are forfeited as of the date that MSRH elects to accept the dog.
2. Yes, I am the owner and I understand
3. Name Of Dog To Be Surrendered(required)
4. Please answer the following questions True or False
5. I have never possessed registration papers; It is unregistered False True (required)
6. Animal is registered; I'm surrendering registration papers False True (required)
7. Animal licensed THIS YEAR; I'm surrendering license/rabies tags False True (required)
8. Animal tattooed/registered with national registry; I'm surrendering certificate False True (required)

Your Information

1. Owners Name(required)
2. Owner's Address (required)
3. Address Line 2 if needed
4. City(required)
5. State(required)
6. Zip Code(required)
7. Phone Number (best contact number)(required)
8. Alternate Phone Number
9. Email(valid email required)
10. How did you hear about us or how were you referred to us?

Information On Dog To Be Surrendered

1. Why are you giving up this dog?
2. Animal Date of Birth or Approximate Age(required)
3. Animal Gender Female Male (required)
4. Is dog spayed / neutered? No Yes (required)
5. Animal Color Salt & Pepper Black White Silver Other (required)
6. If color is "Other", please describe
7. Are the ears natural or cropped?
8. Is the tail natural or docked?
9. What is the dog's approximate weight?
10. Is animal microchipped? No Yes Don't Know (required)
11. License Number
12. Rabies Certificate Number
13. Microchip or Tattoo Number
14. Veterinarian Name
15. Veterinarian Address
16. Veterinarian Phone Number
17. Is dog up to date on its shots? No Yes
18. What food does the dog receive?
19. Is the dog on any medication? Yes No
20. If 'yes', please explain
21. What heart worm preventive does the dog take?
22. How is the dog at the vet's office or groomers?
23. What treats are provided?
24. What commands does the dog know?
25. Is the dog crate trained? House trained? Explain.
26. How is the dog around children of various ages? Explain.
27. Does the dog get along well with other dogs? Explain.
28. What does the dog fear (fireworks, storms, etc)?
29. Does the dog have separation anxiety? Explain.
30. What does the dog 'like to get into'? Explain.

And Finally

1. Owner wishing to surrender their dog acknowledges that by signing this form, by virtue of clicking "I Agree", that he/she will have no further ownership interest in the animal. MSRH is not obligated to take this dog simply because the form has been completed. MSRH will contact you directly with a decision regarding our ability to bring the surrender into MSRH.
2. I Agree
3. Upload photo of the Schnauzer to be surrendered
4. Are there any other comments you wish to make?
5. MSRH Use Only: MSRH Volunteer(s) authorized to accept surrendered dogs will acknowledge receipt of this form and their decision by filing form electronically along with email notation or by printing / filing the form and signing / dating the form.

 

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