/info/file?file=21681.docx
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County
Email*
Home Phone*
Cell Phone*
Alt Email*
Deciding to part with a family pet is an extremely difficult decision and we understand your concern for their well being. You can help us find the best foster home and eventually a perfect forever home by answering each question honestly.
List the name(s) of the dog(s) or cat(s) being surrendered*
Why are you surrendering them?*
Where did you get them? (Many rescues require you to return the pet to them in the event of a surrender. Does your contract require the pet be returned to the original rescue?)* Choose one: Breeder Newspaper/Internet Ad Family/Friend Found-stray Pet Store Rescue Group Shelter Other
If adopted through a rescue/society or shelter, list their name and phone number.
Are you willing to foster with the CPS Community Foster Program?* Choose one: Yes No I don't know
The Community Foster Program is essentially a partnership between you and Cabarrus Pets Society. CPS will become the legal owner and will provide all the food and medical care for the animal(s) while you continue to provide a safe and loving home . We will work together until the animal(s) is adopted into safe, and appropriate permanent home(s) but we have no way of knowing how long it will take to find a new home and it could be days or even months.
Is it a stray? (If yes, contact local animal control for instructions & have it scanned for a microchip)* Choose one: Yes No
If you find a stray
Sex:* Choose one: Female Male
Is it a * Choose one: Cat Dog
Breed?*
How old is the dog or cat? (in years)* Choose one: 0 - 2 3 - 5 6 - 8 9 - 11 12 - 15 16 +
How long have you owned? (years)* Choose one: 0 - 2 3 - 5 6 - 8 9 - 11 12 - 15 16 +
Is the animal spayed or neutered?* Choose one: Yes No I don't know
Current weight in pounds (approximate is OK)* Choose one: 0 - 10 11 - 20 21 - 40 41 - 60 61 - 80 81 - 100 101 - 130 131 plus
Is the animal micro-chipped?* Choose one: Yes No I don't know
Primary coat color(s) Choose all that apply: Black Brindle Brown Fawn Gray Orange Sable Tan White
Secondary Coat Color* Choose one: Black Brindle Brown Fawn Gray Orange Sable Tan White
The coat length is* Choose one: Short Medium Long
Primarily lives* Choose one: Both inside and outside Inside Outside Outside in a fenced area Outside on a chain or leash
If they are kept outside please describe their area
Please list all current pets in your household, including name and type of animal (e.g. Sparky, dog). If none, please type "none".*
Please list any other pets you have owned in the past 10 years, including name and type of animal. If none, please type "none".*
List the name and phone number for the veterinarian that cares for your animals
The veterinary records are under what owner's name and phone and phone number? (If not sure list all possibilities)
We call all veterinarians and review all medical records as part of the Surrender Application Process. If the animal is a stray, contact your local animal control first and have them scanned for a microchip.
Are the vaccines up to date?* Choose one: Yes No I don't know
Has the dog or cat had any of the following medical conditions in the past or currently? Choose all that apply: Allergies Arthritis Ear Infections Heart worms Hypothyroidism Intestinal Parasites
Has the dog or cat had any of the following medical conditions in the past or currently? Choose all that apply: Glaucoma/Cataracts Diabetes Heart Disease/Murmur Kidney Disease Urinary Stones/Infections
Any surgeries, injuries or other medical problems not listed above?* Choose one: Yes No I don't know
If yes, please explain:
List any medications and/or special foods requirements
Know any commands? (to select more than 1 hold down the shift key while selecting) Choose all that apply: Beg Come Crate Down Go Potty Leave it Off Rollover Shake Sit Speak Stay
House trained or litter box trained? * Choose one: Yes No I don't know
Their energy level is best described as* Choose one: High Medium Low
How would you describe the pet? Choose all that apply: Constant companion Destructive Easy going Friendly Lap pet Obedient Quiet Talkative
Any separation anxiety? If yes, please explain*
Are they protective of your home or family?* Choose one: Yes No I don't know
If yes, please explain
How do they respond to strangers? (to select more than 1 hold down the shift key while selecting) Choose all that apply: Barks at first then okay Doesn't care Everyone is a friend Good once they know them Runs and hides Shy Will bite
When visitors come to your home the pet(s)* Choose one: Have to be put away Is social and friendly Is unsocial and unfriendly
Are they protective over food, bedding, toys, etc? If yes, please explain
Any of the following behavior issues? (to select more than 1 hold down the shift key while selecting) Choose all that apply: Biting/Aggression Chew plants Chew electric cords Climb curtains Escaping Jumping on counters Scratch furniture/other things Spraying or marking Other
Any grooming issues? Feet? Ears? If yes please explain.*
Have they lived with or been around dogs?* Choose one: Yes No I don't know
What was the reaction towards them? (to select more than 1 hold down the shift key while selecting) Choose all that apply: Afraid or fearful Aggressive Chases them Does not mind Dominant Playful Submissive
Have they lived with or been around cats?* Choose one: Yes No I don't know
Have they lived with or been around livestock, rabbits, or birds?* Choose one: Yes No I don't know
Describe their reactions and behaviors towards men and women? Do they prefer males only or females only? Does long hair, glasses, facial hair or other characteristics trigger responses. *
How are they around children? (to select more than 1 hold down the shift key while selecting) Choose all that apply: Afraid or fearful Aggressive Does not mind Friendly Ignores Other Playful
Have they ever bitten, snapped at, attacked, or shown any signs of aggressive behavior with children, adults and/or other animals? Please explain*
Had any obedience training?* Choose one: Yes No I don't know
Do they beg for food or counter surf? If yes, please explain
Walks well on a leash? Choose one: Yes No I don't know
Would they run away if unleashed?* Choose one: Yes No I don't know
Have they jumped over or dug under a fence? Choose one: Yes No
Is pet suitable for a home without a fenced yard?* Choose one: Yes No I don't know
Is pet suitable for an apartment?* Choose one: Yes No I don't know
Any fears? Choose all that apply: Baths Children Fireworks Men Other Rain Thunder Vacuum Women
Crate training* Choose one: Uses crate regularly Some experience No crate experience
How much freedom do they have?* Choose one: Free roam Limited to certain areas
How much time are they alone during the day?* Choose one: 0 --3 hours 4 --8 hours 9+ hours
When you leave the house they are Choose all that apply: Crated Chained outside Loose in the home Outside in a fence Outside in a kennel Outside in the yard Restricted to certain rooms
When left alone they Choose all that apply: Bark Chew on furniture/personal items Cries Scratches on doors or windows Urinates/Defecates Is fine
Describe what the best home environment would be*
How did you hear about Cabarrus Pets Society?*
Cabarrus Pets Society’s Surrender Program requires photos of the dog or cat with your application.
The photos must be emailed to CABARRUSPETS@GMAIL.COM. We will not evaluate your pet(s) or review your application until we receive the photos.
After we receive the required photos, we will review your application and let you know the next steps and options available.
Important : Reviewing your application and evaluating your animal(s) does not guarantee acceptance into our Community Foster Program
