Abandonment form

Surrender Form

"*" indicates required fields

Would you like a staff member to give you advice on how to keep your pet?*

Yes

Merci de nous contacter pour prendre un rendez-vous : 450 655-2525 ou info@proanima.com

Date de votre rendez-vous :*

Désirez-vous qu’un employé vous donne des conseils pour garder votre animal ?*

Oui

Non

Please provide your phone number:

General informations

Name*

First Last

Phone*

Email*

Address*

Number and street Apartment ZIP Code

City*

We offer abandonment service only in the cities that are listed here. If your city does not appear there, you are not entitled to the service.

Pet's infos

Pet’s name:*

Species:*

Dog

Cat

Rabbit

Other (please specify) :

Other (please specify) :*

Age:*

Colour:*

Sex:*

Male

Female

Sterilized*

Yes

Declawed

Yes

How many paws are declawed:

2 paws

4 paws

How long have you had the animal?*

Why do you have to abandon your pet?*

Specify:

Who lives with the animal*

Child(ren) under 6 years old

Child(ren) over 6 years old

Adult(s)

Elderly person(s)

Dog(s)

Cat(s)

Other animal(s)

Your environment is:*

Rather quiet

Rather noisy/active

Does he get along with everyone in the house?*

Yes

Specify :*

Has he ever bitten an animal or a human?*

Yes

Please explain the circumstances:*

Has he ever seen a vet?*

Yes

Does he have any known health problems?*

Yes

Please specify known health conditions:

How does he behave at the vet:

If you have your animal's medical file, please attach it to this form:

Drop files here or

Accepted file types: jpg, pdf, png, Max. file size: 8 MB.

You don't have your pet's medical records? Please tell us the name and city of your veterinary clinic so that we can contact them directly.

What food does he eat:*

Daily quantity and frequency:*

Cleanliness of the animal (several choices possible):*

Has always been potty trained (goes outside or uses a litter box)

Use a pee pad

Is occasionally clean (sometimes escapes)

Urine on furniture/carpets

Defecates on furniture/carpets

Not clean for a while

Was never clean

Personality of the animal (several choices possible):*

Other (please specify) :*

Reaction to the visit:*

fearful

Vocal

Excited/jumps

Agressive

Fear of men

Other (please specify) :

Other (please specify) :*

Reaction to unknown or visiting children:*

Friendly

fearful

Vocal

Excited/jumps

Agressive

Don’t know

Never been in contact with children

Other (please specify) :

Other (please specify) :*

Reactions towards other dogs:*

What type of toys does he like?*

Plastic toys

Bones

Noisy/squeak

Fabric

None

Other (please specify) :

Other (please specify) :*

Is he used to the cage?*

Yes

Comment on the cage:

What does he do when left alone?*

Cries/barks

Destroy

Urine/defecation

Stay calm

Other (please specify) :

Other (please specify) :*

How long does he stay alone in a day?*

Describe your daily activity (type of exercise, frequency and duration):*

Further information :*

Other (please specify) :*

Further information :

Does the cat like to be with children:*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Does the cat like to be around other cats:*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Does the cat like to be in the presence of other animals (dogs, rabbits, etc.):*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Does the cat like to go outside:*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : jouer*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : se faire prendre*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : se faire flatter*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : se faire brosser*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : se cacher*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : grimper/être en hauteur*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

Comment réagit votre chat face à la chose suivante : aller voir la visite*

Aime

N’aime pas

Est indifférent

Va mordre/griffer

N/A

What does the cat dislike (describe its reaction):*

Further information :

How big was his cage?*

How many times did he go out per day:*

Does the animal like:*

To play

To be held

Getting brushed

Hiding

to be caressed

Being with children

Being with other pets

Describe what he doesn't like and his reaction:*

Further information :

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General informations

Pet's infos

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