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Voluntary Surrender Form

I do hereby release ownership of my cat/dog. I understand that upon giving my dog to the above named person, that person becomes the sole owner of the cat/dog. I will make no attempt to reclaim my cat/dog. I fully grant this person the right to give my pet any medical treatment deemed necessary, and to possibly place the pet in a good adoptive home. Should a veterinarian determine my pet is too ill to be treated, if necessary, I give the above named person the right to put said dog humanely to sleep. I release the above named person from all liability concerning said animal, and the above named person will make every attempt to provide adequate care and find a permanent home.

I HEREBY STATE THAT I AM GIVING UP MY PET OF MY OWN FREE WILL
Pet's Name:*

Breed:*

Color:*

Age:*

Birth Date:*

Sex:*

Male

Female

Other

Current Veterinarian:*

Current Veterinarian Phone:*

By typing in my name I agree to the terms above.
Client Name:*