First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

Is your pet currently up to date on Rabies and you have documentation to prove this? (If the pet is over 4 months of age this is the law and you must have this documentation. If pet is a stray please download our Stray Handout http://www.cara-nc.org/info/file?file=16064.pdf)

Does your pet have a current Heartworm test if a dog or a Feline Leukemia/FIV test if a cat? (if not if you are willing to have these tests completed at your expense before a scheduled evaluation you can choose yes)

Have you ever had to give up or find another home for a pet in the past?*
Choose one: Yes No

If yes, please explain:

Please list the following: Pet's Name: Animal Type: (cat, dog, breed, etc) Animal Type: (cat, dog, breed, etc) Pet's Age: Pet's Gender: Pet's Breed or Mix: Pet's Color: Pet's Weight: *

Please enter all the information in the area provided: Pets Veterinarian (Please submit separate profile for each pet.) Is pet up to date on vaccinations? Is pet spayed/neutered? Has pet ever been to a veterinarian for anything besides routine vaccinations? If yes, please list or describe reasons for non-routine.*

How long have you owned this pet? * This pet spends most of its time? * Where did you get this pet? * This pet is litterbox/housetrained. * Please describe how this pet reacts to visitors. * Please describe how this pet reacts to other animals. *

Reason(s) for wanting to give up this pet. Please be VERY detailed. * Please describe any behavior issues that you've observed with this pet. Please be VERY detailed. Have you taken steps to resolve or remedy the reasons that are causing you to give up ?*

The final step in the surrender application is sending cara@cara-nc.org a photo of the pet or pets you are looking to surrender. Without a photo the surrender application will be considered incomplete. We need to receive photo within 72 hours of submission. By clicking Yes below you understand.