Pet Surrender Form

Please select your municipal council*

Owner Details

Address Apartment Number

Address Street Number*

Address Street Name*

Address Street Type*

Address Suburb*

Mailing Address Apartment Number

Mailing Address Street Number*

Mailing Address Street Name*

Mailing Address Street Type*

Mailing Address Suburb*

Email*

Contact Number*

Alternative contact number

Your Pet Details

Is this a litter of puppies/kittens from your own mother cat/dog?

If yes, would you be interested in our Last Litter Program which offers free desexed of your mother cat/dog?

Please explain in description box the amount of animals you are needing assistance with if more than one. I.e. 1 x dog + 1 x cat

What is the name of your pet?*

Please specify which name belongs to which pet if surrendering more than 1.

What is the name of your additional pet?*

Please specify which name belongs to which pet if surrendering more than 1.

Size of pet

Size of additional pet

Age of your pet

Please note: If you are surrendering a dog that was born after 26th of May 2017, by law you must have a valid supply number upon surrendering the animal. You can apply for your supply number here https://qdbr.daf.qld.gov.au/ NOTE: Please note individual ages of your pets.

Age of your additional pet

Please note: If you are surrendering a dog that was born after 26th of May 2017, by law you must have a valid supply number upon surrendering the animal. You can apply for your supply number here https://qdbr.daf.qld.gov.au/. NOTE: Please note individual ages of your pets.

Gender of your pet

Gender of your additonal pet

What is the breed of your dog/puppy?

What is the breed of your additional dog/puppy?

What is the breed of your cat/kitten?

What is the breed of your additional cat/kitten?

Please give breed if not available in drop box above.

What is the breed of your Bird, Rat or Guinea Pig(s)?

Is your pet/s vaccinated?*

Is your pet/s up to date with flea, tick and worming treatments?*

Is your pet/s microchipped?

Microchip number

Additional pet Microchip number

Breeder Identification Number (BIN)

Please note: If you are surrendering a dog that was born after 26th of May 2017, by law you must have a valid supply number upon surrendering the animal. You can apply for your supply number here https://qdbr.daf.qld.gov.au/.

Brief description of why you need to surrender your pet/s*

Is there anything that would help you keep your pet?

Do you need help by a certain date?*

Please note: This is a guideline for our team and it is not gauranteed we will be able to assist prior to this date due to the amount of applications we receive.

Home Information

Where did you get your pet from?

How long have you owned your pet?*

Does your pet live inside, outside or both?

How much time does your pet spend alone?

Not including night time sleeping hours

When no one is home, where is your pet kept?

Where does your pet sleep at night?

How many adults live in the home with your pet(s)?

Are there children who live in the home with your pet?

Sociability with children.

Is your pet social with children in the home?

Note: If no, please explain in description box below

What behaviour (s) does your pet display around children in general?

Please describe how your pet interacts with the children in your home.

Has your pet ever bitten/been aggressive to a child in or outside of the home?*

If yes, please describe the incident. If no, please give a brief description of how they interact.*

Note: If yes, please explain in detail.

Has your pet met children other than immediate family?*

If yes, who have they met? Relatives/children's friends/children on walks or in parks? and how do they interact?*

Sociability with adults.

Is your pet social with adults in the home?

Note: If no, please explain in description box below.

If no, please describe what behaviour(s) your pet displays.

If yes, please describe what behaviour(s) your pet displays.

Has your pet met adults other than immediate family?*

How does your pet behave when visitors come to the house?

How does your pet behave with people outside of your home?

Has your pet bitten/been aggressive to an adult in the home?*

Has your pet bitten/been aggressive to an adult outside of the home?*

If yes, please explain what happened.

Sociability with pets in the home

Are there any other pets in the home?*

If so, what kind of animals does your pet live with?

If other pets in the home, how does your dog/cat interact with them?

If aggressive, please explain the behaviour(s) the pet you are needing to surrender displays.

Which pet arrived in the home first?

Is your pet comfortable with other pets and humans being around when they are eating?

If no, what do they do? Ignore/keep eating/stop eating/move away/growl?

Has your pet ever been in a fight with any of the pets in the home?

Do you know who started the fight, what it was over and were there any injuries sustained?*

Sociability with animals outside the home

Has your dog met other dogs?*

If yes, how did they react?*

Has your dog met other cats?*

If yes, how did they react?*

How does your dog react if they see another dog when out walking?

Has your pet ever gotten into a fight or attacked another animal?*

If yes, please describe incident and if there were any injuries sustained.*

Did your pet start the fight?

Do you know what caused the fight to start? Please explain*

Behaviour information

Does your pet have any problem behaviours? Digging/barking/chewing/scratching/destructive?*

If yes, please describe what they do?*

Is there anything that may scare your pet or cause them to be fearful?*

If yes, please explain what causes them to be fearful.*

How often is your dog exercised?

Is your pet independent and likes to be left alone?*

If no, please explain any behaviours observed:

Has you dog had training or attended classes?

Has your pet ever escaped your yard?*

If yes, how do they get out?

What type of fencing do you have?

What is the height of your fence? 3ft/4ft/5ft/6ft/6ft+?

Is you dog currently or has dog ever been regulated by a council?*

(Declared dangerous, menacing or restricted breed)

If yes, please describe*

Health and Veterinary Information

Does your pet currently have any medical or health conditions?*

If yes, please explain:*

Has your pet previously had any medical or health conditions?

If yes, please provide details:*

When did your pet last go to the vets?*

New home recommendations

Can you describe your pet's personality in a few words?*

Note: if surrendering more than one animal, please provide details for each of them.

What sort of home/family do you think your pet would suit?*

Note: if surrendering more than one animal, please provide details for each of them.

Adding some of your favourite photos will help AWLQ to promote your pet for rehoming. Please note that this is optional.

Max. file size: 50 MB.

Photo 1

Adding some of your favourite photos will help AWLQ to promote your pet for rehoming. Please note that this is optional.

Max. file size: 50 MB.

Photo 2

Surrender Conditions

Once AWLQ have received this form you will be placed on the waiting list. This timeframe varies depending on the amount of applications we are receiving and animals we are assisting from external pounds each week. An AWLQ staff member will contact you if they require any further information. You will be contacted to book a day and time to bring your pet to the rehoming centre. A booking must be made for all surrenders as this assists us in maintaining our promise to never euthanise a healthy, sociable and treatable animal in our care.

Please note that AWLQ request a surrender fee of $50 for individual animals and $80 for litters or groups of animals. AWLQ have a last litter fund program which offers owners who have surrendered a litter with a voucher to desex the mother for free. Please ask our staff for more information or contact our National Desexing Network program directly on info@ndn.org.au

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