Surrender A Pet :

Use the form below to tell us about the pet you would like to surrender.

Full Name :
Email :
Address :
City :
State :	Zip :
Phone :
Pet Name :
Type of Pet :
Breed(s) :
Sex of animal :	Spayed / Nuetered :
Male Female	Yes No
Age :
Surrender Date :
Reason for Surrendering :

© copyright 2007 Dodge County Humane Society :: All Rights Reserved :: office@dchs-wi.org
Dodge County Humane Society :: 210 Stoddard St. Beaver Dam WI, 53916 :: 920.887.7447 :: Fax:920.887.7947
501(C)(3) Not For Profit Organization