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Surrender
Surrender
Cynthia
2025-10-11T15:53:46-04:00
We understand that surrendering your Labrador Retriever is a very difficult decision, and we are here to help without judgment. This application allows us to gather the information we need to assess your dog for acceptance into our program and determine the best possible next steps.
Please note:
We prioritize surrender applications for dogs located in Florida and due to insurance requirements are unable to accept Labradors that are mixed with breeds considered dangerous. Additionally, we only accept mixed-breed dogs that are predominantly Labrador Retriever.
Our surrender process can take time, and submission of this form does not guarantee acceptance. Please answer all questions as honestly and thoroughly as possible so we can properly evaluate your request and provide appropriate guidance.
If you need to find placement for your dog immediately, we encourage you to contact your local humane society for assistance.
Your Information
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
(Required)
Alternate Phone
Email
(Required)
Preferred Contact Method
(Required)
Email
Phone (Voice)
Text
Names and ages of all people living in the household with the dog
(Required)
Are you the legal owner of the dog?
(Required)
Yes
No
How did you come to possess this dog?
(Required)
(e.g. stray, breeder, adopted from a shelter, family member, etc.)
Why are you surrendering the dog?
(Required)
What is your desired timeline for surrender?
(Required)
How did you hear about Sunshine State Labrador Rescue?
(Required)
Social Media
Search Engine (Google, Bing, etc.)
Print Media (Sign, magazine, etc.)
Friend or Family Member
In-Person Event
Other
Dog Information
Dog's Name
(Required)
Primary Breed
(Required)
Other known breeds (if mixed)
Age
(Required)
Enter the dogs age to the best of your knowledge. For example 6 months.
Gender
(Required)
Female
Male
Color(s)
(Required)
Is the dog spayed or neutered?
(Required)
Yes
No
Unknown
Is the dog microchipped?
(Required)
Yes
No
Unknown
Microchip Brand
(Required)
Enter unknown if you don't know the brand.
Microchip Number
(Required)
Enter unknown if you don't know the brand.
Pictures of the Dog
Upload three (3) pictures clearly showing the dog's face and body
Upload first picture here
(Required)
Upload second picture here
(Required)
Upload third picture here
(Required)
Medical History
Heartworm Status
(Required)
Heartworm Positive
Heartworm Negative
Unknown
Date of Last Heartworm Test
(Required)
MM slash DD slash YYYY
What brand(s) of Heartworm and Flea preventatives do you administer?
(Required)
Enter brand names, frequency and when was the most recent dose of each. If you don't use Heartworm or Flea Preventatives enter "none".
Date of last Rabies Vaccination
Leave blank if unknown
MM slash DD slash YYYY
Date of last Bordetella Vaccination
Leave blank if unknown
MM slash DD slash YYYY
Date of Last Distemper/Parvo Vaccination (e.g. DHPP, DHLPP)
Leave blank if unknown
MM slash DD slash YYYY
List any prescription medications
(Required)
Enter None if there are none.
List any chronic medical conditions (e.g., diabetes, thyroid disease, heart disease)
(Required)
Enter None if there are none.
List any mobility issues (e.g., arthritis, hip dysplasia, paralysis, difficulty walking)
(Required)
Enter None if there are none.
List any recent surgery or post-operative care required
(Required)
Enter None if there are none.
Describe any blindness or vision impairment
(Required)
Enter None if there are none.
Describe any deafness or hearing impairment
(Required)
Enter None if there are none.
Describe any skin conditions (e.g., allergies, infections, mange)
(Required)
Enter None if there are none.
Describe any digestive issues or special diet required
(Required)
Enter None if there are none.
Describe any history of seizures or neurological disorders
(Required)
Enter None if there are none.
Describe any other heath or care requirements (e.g. senior dog needs help getting into the car)
(Required)
Enter None if there are none.
Veterinarian Contact Information
(Required)
Supply the Veterinarian Name, Clinic Name, Phone Number, and Address. If you don't have a veterinarian enter "none".
Behavior
How does the dog interact with people?
(Required)
Check all that apply.
Friendly / Outgoing
Shy / Timid
Confident
Independent
Submissive
Protective / Guarding
Fearful / Anxious
Aggressive
How would you classify the dog's energy level?
(Required)
Very Active / High Energy
Moderate Energy
Low Energy / Couch Potato
What is the dog's level of training?
(Required)
Well-Trained / Obedient
Knows Basic Commands
Needs Training
House-Trained
Not House-Trained
List any known commands
How is the dog's behavior with other animals?
(Required)
Good with Other Dogs
Selective with Other Dogs
Not Good with Other Dogs
Good with Cats
Not Good with Cats
Good with Small Animals (rabbits, etc.)
High Prey Drive
List any other animals the dog gets along with
List any other animals the dog doesn't get along with
Has the dog ever bitten any person or animal?
(Required)
Yes
No
Explain the dog's bite history
(Required)
Describe any other aggression the dog has shown toward another dog
(Required)
Enter None if the dog hasn't shown aggression.
Describe any aggression or defensive behavior around food
(Required)
Enter None if the dog hasn't shown aggression or defensive behavior around food.
Describe any anxiety (storms, separation anxiety, etc.)
(Required)
Enter None if the dog doesn't show anxiety.
Owner Certification and Relinquishment of Ownership
By signing below, I certify that all information I have provided in this application is true, complete, and accurate to the best of my knowledge. I understand and agree to the following:
1. My dog must be evaluated by Sunshine State Labrador Rescue, Inc. (“SSLR”) for breed, temperament, health, and overall suitability for the foster program.
2. I will provide complete and accurate medical records for my dog at the time of the evaluation.
3. Submission of this application does not guarantee that my dog will be accepted into SSLR’s foster program.
4. If my dog is accepted, I understand that at the time the dog is transferred to SSLR, I am permanently relinquishing all ownership, rights, and claims to the dog. At that time, the dog becomes the sole property of SSLR.
5. I understand that once I relinquish my dog to SSLR, the dog will not be returned to me under any circumstances.
By signing below, I acknowledge that I have read, understood, and voluntarily agree to the terms outlined above.
Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Please consider making a donation toward the care of the dog at the time of surrender
Sunshine State Labrador Rescue, Inc. is committed to equal opportunity. We do not discriminate on the basis of race, color, religion, gender, gender identity, national origin, disability, or any other characteristic protected by applicable law in our volunteer, surrender, or adoption processes.
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