First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Name of animal(s) you are relinquishing:*

Gender of animal(s) you are relinquishing:*
Choose one: Male Female Unknown

Breed of animal(s) you are relinquishing, if known:*

Physical description (i.e. hair length, color, pattern, etc.) of animal(s) you are relinquishing:*

Does this animal(s) get along with... (Select all that apply):

Does this animal(s) have any special needs whether medical, environmental, dietary, etc.? If so, please explain:*

Age of animal(s) you are relinquishing (provide exact birthdate if known):*

Has this animal(s) been spayed/neutered?*
Choose one: Yes No Unknown

Is this animal(s) up to date on vaccinations?*
Choose one: Yes No Some Unknown

I certify that I am the legal owner of the animal(s) being relinquish to Raining Cats 'n' Dogs.*
Choose one: Yes No

I understand that by relinquishing ownership of the animal(s) to Raining Cats 'n' Dogs that I no longer have any legal rights with regard to the animal(s).*
Choose one: Yes No

I agree to release all veterinary records regarding the animal(s) to Raining Cats 'n' Dogs. *
Choose one: Yes No

I have called my vet and authorized the release of all vet records to Raining Cats 'n' Dogs.*
Choose one: Yes No N/A

The name and phone number of my vet is:*

I understand that Raining Cats 'n' Dogs will make every attempt to find the animal(s) a permanent, responsible home.*
Choose one: Yes No

I understand that Raining Cats 'n' Dogs is an animal rescue organization dedicated to reducing the needless euthanasia of companion animals. I understand that occasionally circumstances may arise in which an animal must be euthanized due to health, poor quality of life, and/or behaviors that pose a risk to people or other animals.*
Choose one: Yes No

I have read and understand the conditions for relinquishing my animal(s) to Raining Cats 'n' Dogs. By typing my name below, I am agreeing to comply with all terms of this contract.*

Today's Date:*