Application to Surrender

a Ferret to the

Ferret Rescue

and Halfway House

(CLICK for print-friendly PDF version of this form)

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Ferret Rescue and Halfway House, Inc.

Mason Lowrey, Owner

7150 State Road 44                                                                                    DATE_____________________________

Martinsville, IN 46151

Phone  (765) 349-0265

Fax      (765) 349-4741

 

 I _______________________________ certify that I am the owner of the pet(s) surrendered to Ferret Rescue & Halfway House. I also understand that this is a "no-kill" Facility and that home will be found for all pets surrendered unless there is a health problem and no resolution is possible.

 

Address of owner __________________________________________  Phone: ___________________________

 

City _______________________________________  State __________________  Zip ____________________

 

Description and Profile of Pet:

 

Name _____________________________________ Color  __________________  Sex  _____________

 

Age of Pet _______________   Neutered/Spayed  Yes _____   No _____

 

Behavior: Biter?  _______________________

 

Social Characteristics:  

 

Likes cats __________    Dogs  __________  Children  __________  Other ferrets  __________

 

Training:

Amount of freedom ____________________________________________________________________________

 

Box trained _______________  Paper trained _______________  Untrained _______________

 

Pet kept outside _______________

 

Diet; has been fed "People food"   Yes _____________   No ________________

 

Type of food:  Dry _______________Brand  ________________________________________

 

                          Canned ___________  Brand _________________________________________

 

                          Water Bowl _______  or Bottle ________________________________________

 

Feeding schedule _______________________________________________________________________________

 

Please list any bad behavior you have noted with this pet. It will aid us in attempting to correct this before the pet is placed in a new home.

Or, at least, we will be able to advise the new owner.

 

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________

 

_____________________________________________________________________________________________

 

List any "fears" the pet has (i.e. thunder, vacuum cleaner)  ________________________________________________

 

List any allergies that you are aware of:_______________________________________________________________

 

List any medical problems experienced:_______________________________________________________________

 

List any surgeries that the pet has had _______________________________________________________________

 

Name of Veterinarian who has cared for this pet:  _______________________________________________________

 

Address _____________________________________________________________________________________

 

City __________________________________ State ___________  Zip___________________________________

 

Vaccinations: Dates ____________________________________  Type, Rabies ________ Distemper _____________

 

Are you the original Owner?  Yes _________  No __________

 

May we call you for additional information if needed?   Yes __________  No __________

 

I acknowledge surrender of the above listed animal and understand that it will be given the best possible treatment and a home will be found at the earliest date.

 

Signature  _______________________________________________________

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Page last updated: Sunday April 06, 2008