Surrender Animal Form

One of our hardworking volunteers will be in touch with you as soon as they can

FILL OUT THE FORM BELOW

Surrender Animal Form

YOUR PERSONAL DETAILS

First Name(Required)

Last Name(Required)

Address - unit/street number and name(Required)

City(Required)

Postcode(Required)

Phone(Required)

Email(Required)

Animal(s) Details

Animal Name(s)(Required)

List all relevant and press "enter" after each name. This sets the order for all listed pets in the following fields.

Dates of birth(Required)

List all relevant and press "enter" after each name. List ages if DOB unknown.

Gender(s)(Required)

List all relevant and press "enter" after each name.

Breed(s)(Required)

List all relevant and press "enter" after each name.

Colour(s)(Required)

List all relevant and press "enter" after each name.

Vet Details(Required)

About the animal(s)

Please be as truthful as you can. No judgement will be passed. This is used to assess that your animal is being placed into the correct foster home and will help us understand your pet better.

Is the animal dog friendly?(Required)

Yes or no? Please provide more info of dogs your animal/s have been socialised with eg size/gender/desexed

Is the animal cat friendly?(Required)

Yes or no? Please provide more info of cats your animal/s have been socialised with eg size/gender/desexed

Is the animal child friendly?(Required)

Yes or no? Please provide ages of children your animal/s have been socialised with

Is the animal spayed/neutured?(Required)

Yes or no? Please provide date this procedure was done and if a certificate will be supplied

Is the animal microchipped?(Required)

Yes or no? Please provide date this procedure was done and if a certificate will be supplied

Is the animal Vaccinated?(Required)

Yes or no? Please provide date this procedure was done and if a certificate will be supplied

Is the animal Wormed?(Required)

Yes or no? Please provide date this procedure was done, what brand was used and if a certificate will be supplied

Is the animal flea treated?(Required)

Yes or no? Please provide date this procedure was done, what brand was used and if a certificate will be supplied

Is the animal FIV tested? (cats only)(Required)

Yes or no? Please provide date this procedure was done and if a certificate will be supplied

How did you get your pet?(Required)

How long have you owned your pet?(Required)

Reason for surrender?(Required)

Please advise in as much detail as possible

File Upload(Required)

Please upload pictures of the animal/s you wish to surrender.

Drop files here or

Max. file size: 512 MB.

All of our pets are:

DESEXED

VACCINATED

WORMED

Microchipped

Legal Disclaimer

Central Queensland Animal Society Inc is a registered Animal Rescue and we do so in accordance with the relevant legislation.
BIN0005415666147

CQASI Adoption Policy

All adoption enquiries must be done via our adotion form. Due to the high volume of animals on death row, our own familes, and paid jobs, we will endeavor to answer your enquiry as quickly as possible.

All our adoptions tend to be local, but we have connections all over QLD so are more than happy to consider all serious adoption enquiries. A house/yard check will be done if we can get a local member (if adoption enquiry is not Rockhampton based) to assist. Please note that we will be treating any potential adoption with the upmost care as the animals safety and welfare is our number one concern.

Surrender Animal Form