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Surrender Request Form

Please complete the following form to surrender a pet to Tails of the
Midwest Rescue. This form does not guarantee that the rescue is able to
accept this pet
. Please remember we are a foster based rescue and can only
accept pets that we have suitable fosters for. Tails of the Midwest Rescue
will contact you for questions and further discussion on the surrender.

 

Please complete the form below

Applicants Name *
Applicants Name
Applicant's Address *
Applicant's Address
Applicant's Phone *
Applicant's Phone
Tell Us About Your Pet
Gender *
(if known)
Is the animal up to date on vaccinations? *
Is the animal spayed/neutered? *
The animal is good with: *
Check all that apply.
If applicable.
Has the animal ever:
Check all that apply.
If applicable.
Please check any behavioral issues the animal may have.
Check all that apply.
If applicable.
By clicking "Submit" below, you agree that all the information on this form is true and complete.
I certify that I am the guardian of this animal and that I am legally entitled to transfer ownership to Tails of the Midwest Rescue. I permanently and irrevocably transfer ownership of this animals, with all rights, to Tails of the Midwest Rescue.