Surrender your pet

Begin the process of surrendering your pet to Yorkie Luv Rescue by completing the form below.

First Name*
Last Name*
Phone Number*
Email*
Address*
City*
State*
Zip Code*
Dog Information
Name*
Age or Date of Birth*
Gender*
Is your pet Spayed or Neutered?*
Weight*
Reason for Surrender*
What would you like us to know about your Dog?*
Has your dog ever bitten a person or another dog? Please explain.*
Medical Information
Does your pet have any medical conditions?*
If yes, please explain:
Veterinarian Name and Phone Number:*
May we contact your veterinarian?*
Are vaccinations up to date?*
Please list any current medications or preventive care (including heart worm care)*
Gets along with children?*
Gets along with other dogs?*
Gets along with other cats?*
Are you willing to make a donation to help with re-homing?*
If yes, how much?

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Dog Information