Dog Relinquishment

We understand that relinquishing any pet is difficult. It helps us to have some basic information about your dog to determine how we can best assist. Please fill out the following form. A director will contact you when we receive this information.

Due to our limited network of foster homes, we are limited to assisting the dogs within a 100 mile radius of our West Chester, PA office. If you are beyond that area, please contact a shelter or group closer to your home.

Basic Information

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

County(Required)

Is this where the dog is located? If not, where is the dog located?(Required)

Phone(Required)

Email(Required)

When is the best time to call?(Required)

Morning

Afternoon

Evening

Are you the dog’s owner? If not, who is and what is your relationship?(Required)

Dog’s name(Required)

Dog's Age(Required)

Breed(Required)

Weight(Required)

Dog's Gender(Required)

Male

Female

Spayed/Neutered(Required)

Yes

Not Sure

Please submit a recent photo of the dog you want to relinquish.(Required)

Accepted file types: jpg, gif, png, Max. file size: 64 MB.

If not spayed or neutered please tell us why and would you be willing to have the dog altered prior to relinquishment or provide a donation to offset the cost of the procedure?

Why is the dog being relinquished? Please be specific.

Is the dog up to date with all vaccinations and veterinary care?(Required)

Yes

Not Sure

Date of last veterinary visit(Required)

MM slash DD slash YYYY

Date of last heartworm/lyme test and the result(Required)

MM slash DD slash YYYY

Does the dog have any medical conditions?

Is the dog on any medications? Please list med and dosage

Have you worked with a trainer or behaviorist to correct any behavioral challenges? For how long?

Has the dog bitten anyone? If so, when and what were the circumstances? Was medical treatment necessary? Please be specific.

How long can you keep the dog?

Is the dog good with other dogs?

How long is the dog typically left alone?

Where is the dog accustomed to being kept? (indoors, outdoors)

Is the dog crate trained, housetrained?

How long have you owned the dog?

Are you aware of the dog's history prior to your ownership? (shelter, stray, etc)

Please list the pets that are currently in your home (breed, weight, age). How has this dog interacted with them?

Consent

This form is for informational purposes only and does not guarantee we will be able to take your dog. ASR does not have kennels and is dependent upon available foster homes. We are unable to take dogs without prior notice allowing for time for an evaluation process. This is done to ensure your dog is placed in an appropriate foster home. We do not have paid staff and the process is supported solely by volunteers. If you require immediate placement, please contact your local shelter. Thank you!

Thank you for providing this information. It will allow us to determine how we can best assist. Please note that all of our dogs are fostered in experienced, private homes. For this reason, we take great care to make sure incoming dogs are compatible with the foster home’s current lifestyle. Our network of local foster homes is limited and we always have a list of dogs waiting for our help so it can often take a significant amount of time to bring dogs into our network. We encourage you to continue searching for a new option for your dog and if you are successful please let us know so that we can close your dog’s file. You can learn more about us by visiting our website and social media venues. A Director will contact you soon.

We are a small group of people with a large amount of dog rescue experience, who came together with a big dream. Join us as we grow and evolve to be not just a rescue, but a friend and a partner to educate the public to enhance the lives of homeless dogs in the PA, NJ, DE, and MD regions.

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Dog Relinquishment

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