Surrender Request

This form is a surrender of ownership. Please answer questions candidly and honestly.
This form becomes legally binding once accepted by MHCR.

Surrender Request Form

Date*
Date Format: MM slash DD slash YYYY
Owner's Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Dog's Name*
First
Breed*
Sex*
Age of Dog*
Is your dog spayed or neutered?
Is your dog UTD on vaccines?
How long have you had this dog?*
Was this dog adopted?*
Who did you adopt the dog from?*
Why are you surrendering your dog?*
Please be as specific as possible. Examples include job change, move, behavior issues (specify), lack of time, inability to contain, doesn't get along with dogs, needs training (be specific).
Do you want to keep your dog while we look for a home?*
How quickly do you need your dog out of your home?*
Has your dog ever bitten a human?*
If yes, please provide details:*
Has you dog ever bitten another dog?*
If yes, please provide details:*
Please mark all that apply:*
My dog:
- is friendly with other dogs
- hasn't really been around other dogs
- is friendly with cats
- hasn't really been around cats
- is good with kids
- shouldn't be with kids
- needs to be the only pet in the home
- is house trained
- has accidents in the house or marks things
- is crate trained
- is trustworthy free roam
- jumps fences
- has separation anxiety
- is destructive if left alone
- is growly with new people
- has a high prey drive
- guarding of food/toys/resources
Has your dog ever killed or seriously injured another animal?*
If yes, please provide details:*
Please provide any additional information you'd like to give us.
Please upload a pic(s) of your dog that clearly shows its face.*
Drop files here or
Please upload vet records.
Drop files here or
By signing my name below, I certify that I am the legal owner of the above described canine. I surrender all claim of ownership to the above described dog to Mile High Canine Rescue without recourse. I will make no effort to reclaim the above described canine. I have supplied truthful information to the best of my knowledge.
I understand that I have chosen to act as a foster for my dog while it is being placed for adoption. I am doing so at my own risk. I agree to reimburse Mile High Canine Rescue, Inc. for any costs incurred by them for my dogs vetting or care if for any reason the dog is not adopted out by Mile High Canine Rescue. Further, I forever release Mile High Canine Rescue and its' directors, officers, volunteers, and assigns from any and all liability and/or claims (whether personal property, injury, or medical) associated with my dog.
I understand this Surrender Form must be accepted by Mile High Canine Rescue, Inc. before it becomes legally binding.
Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Signature*

Foster & Volunteer Resources

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About MHCR

Mile High Canine Rescue, Inc. is a 501(c)3, Colorado non-profit organization established in 2019. We are 100% volunteer run and foster home based. MHCR aims to provide abandoned, neglected, and abused dogs a loving home to grow and learn in until a suitable forever home is found. While in foster care, our dogs are spayed/neutered, heartworm tested/treated, microchipped, and vaccinated. We rescue dogs from Colorado, Texas, and New Mexico.

Hours/Location

MHCR has foster homes spread throughout the state of Colorado.

We do not have a facility and therefore operate by appointment only.

Please Contact Us with any questions!

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This form is a surrender of ownership. Please answer questions candidly and honestly. This form becomes legally binding once accepted by MHCR.

Surrender Request Form

This form is a surrender of ownership. Please answer questions candidly and honestly.
This form becomes legally binding once accepted by MHCR.