MSRH Volunteer Form

Owner Surrender

Owner Information
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell Phone *
Home phone
E-mail *
Owner Confirmation:

I am the legal owner and herby release the custody of my pet to Miniature Schnauzer Rescue of Houston (MSRH) for placement into an adoptive home.
1. The dog will not be destroyed except in the case of terminal or disabling mental or physical illness, or a member of the rescue committee deems the dog unplaceable.
2. The owner may recover the dog only if the dog has not been placed in another home and only by complying with the normal MSRH adoption procedures.
3. All claims to this dog are forfeited as of the date that MSRH elects to accept the dog. MSRH is not required to give the owner who surrenders the dog any updates as how the dog is doing after the surrender.
*

Yes, I am the Owner

Pet Information
Pet's Name *
Age *
Spayed / Neutered *
Gender *
Weight *
Was this pet adopted from MSRH? *

Yes No
Why are you surrendering your pet? *
Color *
If Color is Other, Please Describe

Additional Details *

	yes	No
Injured
Any chronic ilnness
Micro-chipped
Current on rabies
Current on vaccinations

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 *

	yes	No	Do Not Know
Housebroken
Good with People
Afraid of People
Aggressive
Good with Other Pets
Well Mannered
Good with Children

Describe other traits / characteristics not found above
Please upload a picture of your schnauzer *

Upload a File

Cancel of
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. MSRH will contact you directly with a decision regarding this surrender request.
I AGREE *

YES
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