Columbia Second Chance | Dog Relinquishment Form

DOG RELINQUISHMENT FORM

Fill out the form to apply to relinquish your dog to Second Chance.

Dog Relinquishment

Your Name:

Address:

City:

State:

ZIP:

Email:

Home Phone:

Cell Phone:

What is your preferred method of communication?

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Our volunteers will do the best that they can to reach you using your preferred method, but please be aware that they may try other methods as well, so check your junk mail and voicemail!

Name of Dog:

Do you own this dog?

Spayed/neutered?

Gender:

Age:

Breed:

Where did you get your dog?

*If you got your dog from the animal shelter or humane society, add the name of the shelter below:

Vaccination History:

Medical History:

Veterinarian(s) who provided this care:

Veterinarian's phone number:

Why do you need to rehome this dog?

Has the dog ever had conflict with other animals? (dogs, cats, chickens, livestock, etc.)

Has the dog ever bitten or shown aggression toward humans?

Does the dog protect/guard anything? (food, property, toys, owner, etc.)

Does the dog like children? If not, how does he or she display distaste for children?

Does the dog have any fear issues or separation anxiety?

Is the dog reliably housetrained?

Is the dog reliably cratetrained?

Does the dog live inside, outside, or both?

What commands does the dog know?

How many other animals are in the home? What kind(s)?

What time frame do you have to find the dog another home?

Attach a Photo of the pet

Upload File

Other notes or information:

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DISCLAIMER: Completion of this form does not guarantee placement in the Second Chance program. Completed forms will be considered by the intake committee, and we will contact you if we are able to accept your dog into Second Chance.

Please Select an Option.

I want to submit my animal to be adopted via Second Chance.

I want to submit my animal to be listed on the community rehoming page.