Relinquish/Rehome Pet Form

Animals Name/Breed/Age

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Reason for return/relinquishment

Was pet crated?

Yes

If Yes- Crate Size - Average # of hours crated/day?

Where did the pet stay during day/sleep?

Did the pet use a doggy/cat door?

Yes

Is the pet used to being home alone?

Yes

How many hours a day is the pet used to being alone?

Has the pet ever lived with other pets?

Yes

If yes, what kind of pets?

Has the pet lived with children?

Yes

If yes, how many and what ages?

Are vaccinations current?

Yes

Is the pet spayed or neutered

Yes

Veterinary Clinic and Phone #

Health Problems

I/we are returning/relinquishing the above stated pet to YHTASR. I/we understand that this pet will be evaluated and placed/returned into the YHTASR, and that matters concerning the pet, including placement, will be conducted by the staff at YHTASR. I/we freely relinquish ownership of this pet. I/we hereby authorize the verterinarian named herein to release information about me or my pet(s) to YHTASR as necessary to evaluate this application. ONLY SUBMIT THIS FORM ATER PRIOR APPROVAL BY YHT - email: yavitrappers@gmail.com

OWNER SIGNATURE(S) / DATE

YHTASR SIGNATURE RECEIVED BY / DATE

Use only with pre-approval by YHT

Relinquish/ Rehome a Pet

Do you need to Relinquish/Rehome a pet?