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Understanding Owner Surrender

If you are considering having Canine Connections re-home your dog, PLEASE READ THE FOLLOWING CAREFULLY so that you fully understand all the options available to you.

We understand that the decision to give up a pet is rarely one that dog lovers make easily.  Whatever the reason for this heartbreaking decision, we commend you for trying to do the right thing for your dog.  We want to mention two very disturbing facts before we explain our own policies here at Canine Connections.

  1. Please be aware that many shelters are so over-crowded that "owner turn-ins" are the first to be euthanized to make space for the strays that must be kept a specified number of days in order that their owners are given time to locate them.  If you must take your pet to a shelter, try and find a no-kill facility.

  2. Free to Good Home Ads in the newspaper and on the Internet are NOT A GOOD IDEA! This is often how bait dogs (used in dog fighting) are located, as well as pets used in medical testing.  We would not wish that end to come to any animal.

As Canine Connections has grown, we are receiving more and more requests to take in dogs that come from owners and private individuals. In the past Canine Connections has been able to accommodate many of these requests. However, our primary focus has always been to take in dogs from high-kill shelters where Canine Connections may be their only chance at surviving. With limited openings in our all-volunteer rescue which we operate out of our homes rather than at a physical facility, coupled with an increasing number of individuals requesting that we take in dogs, we have revised our surrender policy.

Canine Connections may be able to assist in the process if you are willing to complete this Application to Surrender (below). After we have received the application, we will call or e-mail you to discuss the information provided in the application.  If we decide that we can help you, we will handle it one of 2 ways.

  1. Our Courtesy Postings are dogs that are still living with their owners but need to find a new home.  
    A digital picture of the dog is  required.  We will list your dog's photo and description on our web site as a courtesy post and list your name and contact information (telephone number and/or e-mail address).

  2. If you wish for Canine Connections to screen any applicants, Canine Connections Rescue would be listed as the contact. However this option must be agreed to by both the surrendering party and Canine Connections. And if this option is agreed to, we will require an adoption Contract and our standard adoption fee from any applicant that we screened and forwarded to you whom ended up adopting the dog.


If you'd prefer this application to surrender sent to you via the post office or via email, Email Us to Request an Application. Of course, we will need a complete address.

Owner Surrender Application

Any Application not completed IN FULL will not be processed.  Also we do ask for a donation to our rescue in appreciation for helping you re-home your dog and so that we may continue to help others in need.

Your Contact Information

Any Application not completed IN FULL will not be processed.

Your Full Name
Daytime Phone  Please include area code.
Evening Phone Include area code.
Information About Your Need To Re-Home

Reasons for surrender.  (The more details you can provide throughout this application, the better.)

How long have you had this dog?

How long can you keep the dog?

If stray, where and when was the dog found?

A current photo of the dog and, if available, a copy of the dog's medical records, are required.

Information About The Dog
Dog's Name Breed: Color:
Age: Male   Female Weight:

Spayed/Neutered?  No  Yes  

Crate Trained?  No  Yes

Housebroken?   No Unknown Always  Usually  Partially

Please describe level of obedience training or other relevant comments regarding training.

Information About Temperament

Number of hours dog can be left alone:
0-2 hours 2-4 hours 4-6 hours 6-8 hours 8-10 hours 10-12 hours Unknown

Is the dog good with children?   No  Yes  Unknown
Please specify children's ages or add comments regarding experience with children

Is the dog good with other dogs?   No  Yes  Unknown
Please elaborate with comments regarding experience with other dogs.

Is the dog good with cats?   No  Yes  Unknown
Please elaborate with comments regarding experience with cats.

Has the dog ever snapped, bitten, or shown aggressive behavior towards a:

Man   Woman   Child   Dog   Cat  Others

Please elaborate with as much detail as possible regarding the above.

Has the dog bitten anyone in the last 14 days?  No  Yes  Unknown
If yes, please describe above incident(s).

Please check all that apply:

Puppy-like Friendly Sweet Intelligent Needs Fenced Yard
Gentle Happy Sensitive Eager to please Lap Dog
Playful Loyal Prefers Men Prefers Women Needs quiet home
Protective Obedient Active Shy Laid Back
One Person Crate Trained Needs Obedience Training

Bad Habits:

Fence Jumper Escape Artist Digger Chewer Separation Anxiety
Food Aggressive Fearful in some situations Not Good With Kids
People Aggressive Dog Aggressive Other: Please explain below.

Please provide us with details about the above checked bad habits, or "areas that need improvement."  Even if you want to qualify your answers, for instance you may have checked people aggressive, but only with strangers.  More information is always better and will allow us to place your dog properly.

Information About The Dogs Health

Are there any known medical problems or dietary issues? No  Yes  Unknown

If yes, please describe and include medications or special diet requirements.

Date of last Heartworm Test

Date of last Rabies Vaccine

Date of last Heartworm Pill/Shot

Date of last Distemper Shot

Date of last Flea/Tick Prevention

Your Veterinarian
Vet Name
Vet Phone
Name vet records
are filed under
Almost Done!

If your dog is accepted into our program, Canine Connections will attempt to find a new home for him or her but Canine Connections cannot guarantee that the above dog will be placed.

Potential Adopters must complete an extensive interview, reference & vet checks, as well as agree to a home visit so we are sure your dog's new home is appropriate. Once the adopter is approved, they will complete an adoption contract and pay an adoption fee that is applied toward our rescue expenses.  We are a non-profit organization supported solely by donations and money out of our own pockets.

Depending on your financial circumstances, you may also be asked to make a donation to our rescue.

Are you prepared to sign over this dog to Canine Connections for permanent placement in another home? Yes No

Any other comments you'd like for us to consider:

Your email address.  (Sorry I know we already asked but we need it again.)

How did you find out about Canine Connections Rescue?  Or who referred you? (Please be as specific as possible - Vet, Shelter, Friend, Newspaper, Internet, Other)

Clicking the Submit Button will return you to our website.

If your have any comments or concerns about this program please take a moment to share them with us via email. We are always interested and open to your viewpoint.

Also please let us know if you would like to volunteer!  We need you and the animals need you.

Canine Connections

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© 2008-2009 Canine Connections

Saving Lee County North Carolina's needy dogs - and yes the occasional cat too!

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Last updated: 07/30/2009   
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