Serendipity German Shepherd Dog Rescue
is unable to accept any owner surrender dogs
at this time,
however we may
be able to help.
Learn more...

There are publications on this page that are available as PDF (portable document format) files. To be able to read these files, download the free Adobe Reader.

Click here for a printable PDF version of this dog surrender form or fill out the online form below.

Dog Surrender Form

Please Note: We cannot accept dogs with any aggression issues towards other people, children or other dogs. We can only accept dogs on a space-available basis. If today is Friday and you are moving Monday and cannot take your dog, we are NOT able to help you. Owner surrender dogs should be vaccinated and heartworm tested negative. If they are not, an owner surrender donation of $100 will be required as contribution towards the veterinary costs that we will incur. This donation is tax-deductible. We do not purchase or pay a fee to owners for surrendered dogs. Serendipity German Shepherd Dog Rescue is a not-for-profit Missouri corporation and provides a service to help place German Shepherds in new homes when their present owners can no longer keep and/or care for them.

Owner's name(s): Note that your driver's license number may be requested in a follow-up communication.

Address, City, and State:

Phone:

Email:

Date by which your dog must be re-homed:

Are you willing to continue to care for your dog while we look for a new home for him/her? Yes No

About Your Dog. Your Dog's name:

Gender of your dog: Male Female

Age of your dog:

Date of birth (if known):

Color:

Weight (approx):

Is your dog altered (ie: spayed/neutered/fixed)? Yes No

Is your dog Microchipped? Yes No Don't know

If yes, what is the Microchip number / Agency:

Name and address of your Veterinarian:

Date your dog last saw a vet:

What was the reason for that visit?

Does your dog have any of the following Fleas Hotspots Allergies

If your dog has allergies, what is he/she allergic to?

When did your dog last receive the following vaccinations: Rabies, DHLPP, Bordatella

When is your dog due for their next vaccinations: Rabies, DHLPP, Bordatella?

What date did your dog last receive a heartworm test?

What was the result of the heartworm test?

What kind of heartworm preventative is your dog on?

Does your dog have a history of any injuries or illnesses: (Please give full details):

Are vet records available? If not, please authorize your vet to share information with us. Yes No

How did you originally acquire your dog?

Where do you keep your dog? Check all that apply.   House
   Outside
   Kennel
   Tie Out
   Fenced
   Other

Is your dog Housetrained? Yes No

Is your dog Crate Trained? Yes No

Is your dog Obedience Trained? Yes No

Commands your dog knows:

Where is your dog kept when alone?

Does your dog do any of the following? Check all that apply.   Chew
   Dig
   Jump the fence

How is your dog with strangers?

How is your dog with children?

How is your dog with other dogs?

How is your dog with cats?

How is your dog with livestock?

Has your dog been exposed to children? Yes No

If so, what ages where the children?

What is the overall energy level of your dog?

Does he/she bark excessively? Yes No

Is your dog possessive of any of the following? Check all that apply.   Family Members
   Food
   Toys
   Home

Does your dog have specific fears or phobias? (Storms, fireworks etc.)

Has your dog ever bitten, or attempted to bite any of the following? Check all that apply. Adult Child Another animal

If you checked any of the above, please give precise details of the circumstances:

Please describe the personality of your dog, his/her likes, dislikes, issues, etc.: