About this template
The Animal Surrender Intake Form is a critical tool for animal shelters, rescue organizations, and veterinary clinics tasked with rehoming pets. This form streamlines the intake process by gathering comprehensive information about the animal, including its medical history, behavioral traits, and socialization needs, while simultaneously capturing the current owner's contact details and the reason for the surrender. By centralizing this data, organizations can make informed decisions about placement and care, ensuring the safety and well-being of the animal.
Beyond basic identification, this template includes sections to document vaccination status, spay/neuter history, and specific medical requirements. It also provides a dedicated space for owners to indicate a donation amount to support the immediate costs of vetting and care. Using Doc2Form to deploy this template allows rescue staff to transition away from paper-based intake processes, ensuring that every animal's history is accurately recorded and easily accessible for the team responsible for their future placement.
Key features
- Captures detailed pet medical and behavioral history.
- Standardizes the surrender reason for better placement matching.
- Includes fields for vaccination and spay/neuter status.
- Collects owner contact information for follow-up questions.
- Provides a dedicated space for donation pledges to aid care costs.
Use cases
Processing owner-surrendered pets at local animal shelters.
Documenting medical history for rescue group intake assessments.
Collecting pet background information for foster care placement.
Managing surrender requests for veterinary clinics offering rehoming …
Managing surrender requests for veterinary clinics offering rehoming services.
What this form collects
- Owner Full Name (Short answer)Please provide your full legal name.
- Contact Information (Paragraph)Please provide your email address and phone number.
- Animal Name (Short answer)What is the name of the pet being surrendered?
- Breed and Color (Short answer)Please list the breed and primary colors of the animal.
- Age and Weight (Short answer)Provide the approximate age and current weight in pounds or kilograms.
- Socialization Details (Paragraph)How does the animal interact with children, other dogs, cats, or strangers?
- Medical History (Paragraph)Please provide details on vaccinations, heartworm status, and spay/neuter status.
- Reason for Surrender (Paragraph)Please briefly explain the reason for surrendering the animal.
- Donation Amount Offered (Short answer)If you are able to provide a donation to help cover initial vetting or care costs, please indicate the amount here.
- Medical Records or Photos (Paragraph)Please paste a link to your file (Google Drive, Dropbox, etc.) or describe the document you wish to attach.
FAQ
How can I customize this form for my specific shelter?
Once you convert this template to Google Forms, you can easily add or remove questions, adjust the branding, or include specific waiver language relevant to your local laws.
Can this form collect donations?
While Google Forms does not process payments directly, you can include a link to your organization's payment portal or PayPal in the form description or confirmation message.
Is this form suitable for foster-based rescues?
Yes, this form is highly effective for foster-based rescues to quickly assess the needs of an incoming animal before they are placed in a foster home.
How do I ensure the data remains private?
Google Forms stores data in your connected Google Sheets. You can manage access permissions within your Google Drive to ensure only authorized staff members can view sensitive owner information.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.