1. Please answer the questions honestly and be as detailed as possible. This will help is in determining if we will be able to accept your dog in to our rescue. This information MUST be submitted along with a photograph before we will consider accepting your dog in to our program. If you have made the difficult decision to surrender your dog, the following steps apply:

  2. Address, City, State, Zipcode

  3. If yes please explain

  4. E-Signature

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