Dog Surrender Form Please fill out the form below to surrender your dog. We will contact you with next steps. Dog Surrender Form * Name First Last * Email * Phone * Dog Name * Breed * Age * Sex Male Female * Is Your Dog Spayed or Neutered? Yes No * Is Your Dog's Rabies Vaccination Current With Proof? Yes No * Is Your Dog's DHPPV Vaccine Current With Proof? Yes No * If over 6 years old, has a dental cleaning been done? Yes dental done No dental work Not over 6 * Has your dog bitten anyone? Please describe the situation if yes. * How much can you donate to AZSDR towards this dog's care? * Your dog is: good with small dogs good with large dogs not good with other dogs good with cats * Is your dog on any medications? Yes No If on medications please explain. * Reason for surrender? * Preferred Surrender Date * Please upload a photo of your dog Max file size is 33 MB. Spam folder Understood Thank you for filling out this form. You may need to check your spam folder for our response or other folders in your email.