MSRH Volunteer Form

Additional Details*

	yes	No
Current on rabies
Current on vaccinations

Micro-chipped*
Microchip #
If your dog is injured, please describe
Please list any chronic illnesses you dog has (heart murmur, liver issues, cataracts, etc.)*
If your dog has a vet, please provide vet information (name, location, phone number)*
Please provide date of last vaccinations and ones given to your dog*

Other Characteristics and Traits*

Describe other traits / characteristics not found above. PLEASE note if the dog has been around children or not, other pets, any other items may be important.
Please upload a picture of your schnauzer*

Upload a File

Cancelof
Relinquisher acknowledges that by signing this form, by virtue of clicking "I Agree", that he/she is the owner of this animal and that the animal was originally adopted from MSRH; and/or the relinquisher has the authority to surrender this animal to MSRH, if it did not originally come from MSRH. Relinquisher also acknowledges that by clicking the "I Agree" that all rights to the animal are terminated and he/she has no further recourse. MSRH will contact you directly with a decision regarding this surrender request.
I AGREE*

YES
Enter the message as it's shown*
Should be Empty:

Owner Surrender