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HOME
WHO WE ARE
DONATE
ADOPT
Cat Adoption Application
Lost & Found
Surrendering an Animal
Pet Relinquish Form
OUR SPONSORS
NEWS & EVENTS
Tree Jubilee
Tree Jubilee Donation Form
Doggy Maze Daze
HOW TO HELP
CONTACT
Please submit this relinquish form - All questions are required
*
Indicates required field
Name
*
First
Last
Address
*
Email
*
Pet's Name
*
Gender
*
Male
Female
Breed
*
Cat
Dog
City, State, Zip
*
Phone
*
Pet's Age
*
Breed, Color, Additional Details
*
Doest this pet belong to you?
*
Yes
No
If no who?
*
Why do you need to surrender this pet?
*
What have you done to find a home for your pet other than contacting the Ipswich Humane Group?
(Please answer each item below and include details where indicated.)
Have you put up posters?
*
Yes
No
If yes, where?
*
Have you put an ad in the newspaper?
*
Yes
No
Name of newspaper
*
Asked a Veterinarian?
*
Yes
No
Name and phone of vet or animal hospital contacted
*
Contacted a breed rescue group?
*
Yes
No
Name and phone of group contacted
*
Is your pet posted on Petfinder?
*
Yes
No
Which humane group is it posted under?
*
Have you called other animal shelters?
*
Yes
No
Names of shelters called and their comments
*
Have you asked friends or relatives to take pet?
*
Yes
No
Veterinary Information
Name and phone of your veterinarian or animal hospital
*
Is your pet spayed or neutered?
*
Spayed
Neutered
Neither
Please note veterinarian verification is required
If no, is your pet pregnant?
*
Yes
No
Has your pet been kept
*
Inside
Outside
Both
Up-to-date Rabies vaccine?
*
Yes
No
If your pet is a cat, has it been declawed?
*
Yes
No
Are there any pre-existing medical conditions or ongoing treatments necessary?
*
Are there any behavioral problems with people or other animals? (please explain)
*
Does your pet have any phobias or fears, food preferences, likes, dislikes (especially about being touched), etc: ?
*
With each animal surrendered, the Ipswich Humane Group incurs additional expenses to care for the animal. Please indicate an amount you can donate if your pet is current with rabies vaccine and has already been spayed or neutered.
*
$25
$35
$50
Other
Before coming into the Animal Shelter, all pets must be up-to-date with rabies vaccine (and other shots) and be spayed or neutered.
If your pet is not up-to-date with shots and spayed/neutered
:
Are you willing to have this done by your own veterinarian?
*
Yes
No
If not, there will be an additional charge of up to $200 (depending on what needs to be done) to have this done by one of our own veterinarians.
Are you willing to pay for the Ipswich Humane Group to take on the expense of having your pet vet checked, updated rabies vaccine and other shots, and spayed or neutered?
*
Yes
No
The Ipswich Humane Group gives priority to stray and abandoned animals. If the shelter is full, we will not be able to accept your pet.
You will be notified if your application has been approved or denied.
Please Note:
If your application is
approved
, you will be asked to submit veterinary documentation of your pet’s spay/neuter status, updated rabies vaccine, latest medical history from your pet’s veterinarian
BEFORE your pet can come into the Shelter:
If spayed or neutered, we need documentation of spay or neuter
If up to date on rabies vaccine, we need documentation of last rabies vaccine and expiration date.
If you have been taking your pet to a veterinarian, we need the latest update on any other vaccines and the latest medical history.
Please submit your completed form and a volunteer will contact you to discuss surrendering your pet.
Submit