Owner Surrender Screening Form **INTERNAL USE ONLY**

Owner Surrender Screening Form (INTERNAL USE)

MM slash DD slash YYYY
Urgency of Surrender(Required)
Name of Owner/Guardian(Required)
Fax Vet Records
The Owner Surrender Form has been sent?
Surrender appointment has been booked?
I have instructed the owner/guardian to bring toys, food, leash, bed, etc. upon drop off.(Required)

Notes for Staff

Fast-track animals without medical or behavioural problems providing space is available. Any animals with red flags is considered urgent. Refer request to Adoption/Intake Coordinator or the Animal Care Manager.