Owner Surrender Request

We are not an open admission shelter. You must complete the form below and wait for us to get back to you. Please send a photo of the animal to adopt57@aheinz57.com.

Our team will determine the surrender fee based on the vet care that the animal needs. This does not apply to returns.

Request purpose*
- Owner surrender
- AHeinz57 return
- Stray
Dog or cat?*
- Dog
- Cat
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Reason for surrender*
Date needing to surrender*
Date Format: MM slash DD slash YYYY
Name of dog/cat*
Breed of dog/cat*
Was this dog/cat originally adopted from AHeinz57?*
- Yes
- No
If not adopted from AHeinz57, where did this dog/cat come from?*
Gender*
Age*
Is the dog/cat spayed or neutered?*
Are vaccinations up to date?*
Vet Name*
Vet phone number*
Is the dog/cat good with kids?*
Is the dog good with other dogs? (or vice versa)*
Is the dog good with cats? (or vice versa)*
Describe the animal's personality*
Are there any behavior issues?*
Does the dog/cat have a bite history?*
If yes, please explain*
Other comments