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Northwoods Humane Society
Adoptable Animal Shelter in Hayward, WI
Northwoods Humane SocietyNorthwoods Humane Society
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      • Dog Surrender Form
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Donate!

  • Adoptable Animals
    • Adoption Process
    • Dog Adoption Form
    • Cat Adoption Form
    • Small Animal Adoption Form
  • Get Involved!
    • Donations
      • One-Time Donations
      • Monthly Donations
      • Donate Thrift Items
    • Become a Member
    • Volunteer
      • Foster Home Care Volunteer Application
      • Adult Volunteer Application
      • Junior Volunteer Application
      • Volunteer Photo Gallery
    • Other Ways to Give
    • Visit our Thrift Shop
  • Events
  • Thrift Shop
  • Community Outreach
    • Articles & Newsletters
    • Bark Parks
    • Behavioral Issues
    • Lost & Found
    • Pet Medical Help
    • Spay/Neuter
    • Surrender
      • Dog Surrender Form
      • Cat Surrender Form
      • Stray Surrender Form
  • About Us
  • Contact
  • Home

Dog Surrender Form

All fields are required.
Name(Required)
Address(Required)
Dog's Name
Breed
Age
Male or Female(Required)
Male or Female
Spayed or Neutered(Required)
Spayed or Neutered
Has this dog ever bitten anyone?(Required)
Has this dog ever bitten anyone?
Did it draw blood?(Required)
Did it draw blood?
Please explain the bite indicent
How long have you had this dog?
Age when you got this dog
How did you get this dog?
Why do you want to surrender this dog?
What have you done to re-home this dog? Why did it not work?
Is this dog potty trained?(Required)
Is this dog potty trained?
How does this dog let you know it needs to go out?
Where is this dog used to being kept?(Required)
Where is this dog used to being kept?
Have you seen any of these behaviors?(Required)
Have you seen any of these behaviors?
Choose any that fit this dog.(Required)
Choose any that fit this dog.
Please explain any of the noted behaviors.
Can the dog be left alone for long periods of time?(Required)
Can the dog be left alone for long periods of time?
Choose any that apply. Does this dog NOT get along with:(Required)
Choose any that apply. Does this dog NOT get along with:
Choose any that apply. This dog has NOT had trouble with:(Required)
Choose any that apply. This dog has NOT had trouble with:
Can the dog be trusted alone in the car?(Required)
Can the dog be trusted alone in the car?
Can the dog be trusted alone in fenced yard?(Required)
Can the dog be trusted alone in fenced yard?
If no to either, please explain
Does the dog enjoy car rides?(Required)
Does the dog enjoy car rides?
Does the dog get carsick?(Required)
Does the dog get carsick?
Is the dog crate-trained?(Required)
Is the dog crate-trained?
Where does the dog sleep?
Where is the dog when the family is eating?
Where and how often a day is the dog fed?
Brand/type and amounts?
Has this dog ever been to a vet?(Required)
Has this dog ever been to a vet?
Are vet records available for this dog?(Required)
Are vet records available for this dog?
Please summarize any vet visits, if applicable
What vet and what name is pet listed under?
Contact info for vet, including phone number
Is this dog possessive of food, toys or people?(Required)
Is this dog possessive of food, toys or people?
If this dog is sensitive to being touched, please explain.
Please explain anything else we need to know about this dog to find the right home.
As owner or agent of the owner of this dog described herein, I do hereby assign ownership of said dog to the Northwoods Humane Society. NHS will become the sole owner of the animal and may care for the animal in any manner the society sees fit. To the best of my knowledge, as owner or agent of the owner this animals HAS NOT BITTEN ANY PERSON, in the last 10 days. Please type your name in the box as electronic authorization.
SIGNATURE
DATE
MM slash DD slash YYYY
Please type RESCUE to prove you are human:

Northwoods Humane Society

Hours

Office is Open - Monday - Saturday from 11:00 AM to 3:00 PM.
Animal Tours are by Appointment Monday - Saturday from 11:00 AM to 2 :00 PM.

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Contact Info

Northwoods Humane Society
10812 N O'Brien Hill Road
MAILING ADDRESS:
P.O. Box 82
Hayward, WI 54843

PHONE
(715) 634-5394
EMAIL
paws@northwoodshumanesociety.org

Location

We are located 4 miles east of Hayward on Highway 77 East.

Tax ID Code: EIN 39-1634-807; Dog Seller License 267329-DS
The Northwoods Humane Society (NHS) is a Section 501 (c) (3) charitable organization. Donations to NHS are deductible as a charitable gift.
If you should have any questions concerning tax deductibility, please consult your tax advisor.
The NHS receives NO funds from any local, state or federal government. We are a "no-kill" shelter.

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