I agree to the conditions set on the previous page.(Required)choose yes to continueYes, I agree to the above.Owner InformationFirst name(Required)Last name(Required)Street address(Required)City(Required)Zip code(Required)5 digit only , only Osceola County zip codesOut of Osceola County jurisdiction The zip code on your surrender form indicates that your home is located outside of Osceola County. This program is open only to citizens of Osceola County. If you believe that this is an error, please call Animal Services at 407-742-8000 during business hours and we will check your address with our Osceola County address database. Below are links to animal services surrender programs in our surrounding counties. Orange CountyAnimal Services Orange County Polk CountyAnimal Control Polk County Lake CountyAnimal Control Lake County Email(Required) Enter Email Confirm Email Phone(Required)My current living situation is...(Required)choose oneI have a stable home.I am pending an eviction.I have been evicted and do not have a home.I would rather not say. Proof of eviction is required before or during the appointment. If not available for upload below, please bring a hard copy to the appointment (possible chance of appointment cancellation or denial if not present). Upload fileAnimal Profile(s)â–º Please list smaller animals first.Number of dogs(Required)0123Number of cats(Required)0123This field is hidden when viewing the formTotal surrendersWe cannot accept more than 3 pets on one surrender form.Animal 1Animal 1 name(Required)Animal 1 species(Required)choose onecatdogOtherAnimal 1 dog breed(Required)Animal 1 size(Required)choose one<5 - 10 lbs11 - 20 lbs21 - 30 lbs31 - 40 lbs41 - 50 lbs51 + lbsAnimal 1 color(Required)Animal 1 gender(Required)choose onefemalemaleHas the animal 1 been spayed?(Required)choose onenoyesHas animal 1 been neutered?(Required)choose onenoyesAnimal 1 age(Required)choose oneunder 4 weeks4 - 8 weeks2 - 4 months4 - 8 months9 - 12 months1 - 2 years3 - 5 years5 years +Has animal 1 ever bitten anybody?(Required)choose onenoyesI do not knowDoes animal 1 have any known medical issues including special needs?(Required)choose onenoyesAnimal 1 explain medical issues including allergies or special dietary needsWhat food (brand and type) does animal 1 usually eat?(Required)Animal 1 personality(Required) good with dogs good with cats good with small animals good with small children good with Men good with Women crate trained house broken Food Aggressive Shy Friendly Protective Playful Easy Going none of the above How long have you had this pet?(Required) less than 6 months less than a year 2 - 4 years 5 - 8 years over 8 years Where did you get this pet?(Required) friend pet shop breeder stray an animal shelter Name and location of animal shelter where you got this pet.(Required)Is this pet mostly(Required) an indoor pet an outdoor pet both indoor and outdoor When out doors, is your pet mostly:(Required) fenced in yard kennelled leash walked out on a lead or rope kept with an invisible fence When alone, is your pet mostly(Required) outdoors in a fenced area free in the house confined to a room in the garage crated Does your pet have any fears?(Required)Click all that apply thunder fireworks vacuum other people other pets/animals no fears Does the animal 2:(Required)Click all that apply mind being picked up bark/howl like a bath and grooming chew on furniture and other items walk on a leash sit/lie on the furniture none of the above Animal 1 photo Drop files here or Select files Max. file size: 80 MB. Animal 2Animal 2 name(Required) Animal 2 species(Required)choose onecatdogAnimal 2 dog breed(Required)Animal 2 color(Required)Animal 2 gender(Required)choose onefemalemaleHas animal 2 been spayed?(Required)choose onenoyesHas animal 2 been neutered?(Required)choose onenoyesAnimal 2 size(Required)choose one<5 - 10 lbs11 - 20 lbs21 - 30 lbs31 - 40 lbs41 - 50 lbs51 + lbsHas animal 2 ever bitten anybody?(Required)choose onenoyesAnimal 2 age(Required)choose oneunder 4 weeks4 - 8 weeks2 - 3 months4 - 8 months9 - 12 months1 - 2 years3 - 5 years5 years +Does animal 2 have any medical issues including allergies or special dietary needs?(Required)choose onenoyesAnimal 2 explain medical issues.(Required)What food (brand and type) does animal 2 usually eat?(Required)Animal 2 personality(Required) good with dogs good with cats good with small animals good with small children good with Men good with Women crate trained house broken Food Aggressive Shy Friendly Protective Playful Easy Going none of the above How long have you had animal 2?(Required) less than 6 months less than a year 2 - 4 years 5 - 8 years over 8 years Where did you get animal 2?(Required) friend pet shop breeder stray an animal shelter Name and location of animal shelter where you got animal 2.(Required)Is animal 2 mostly(Required) an indoor pet an outdoor pet both indoor and outdoor When out doors, is animal 2 mostly:(Required) fenced in yard kennelled leash walked out on a lead or rope kept with an invisible fence When alone, is animal 2 mostly(Required) outdoors in a fenced area free in the house confined to a room in the garage crated Does animal 2 have any fears?(Required)Click all that apply thunder fireworks vacuum other people other pets/animals no fears Does animal 2:(Required)Click all that apply mind being picked up bark/howl like a bath and grooming chew on furniture and other items walk on a leash sit/lie on the furniture none of the above Does your pet have any fears?(Required)Click all that apply thunder fireworks vacuum other people other pets/animals no fears Does animal 3:(Required)Click all that apply mind being picked up bark/howl like a bath and grooming chew on furniture and other items walk on a leash sit/lie on the furniture none of the above Animal 2 photo Drop files here or Select files Max. file size: 80 MB. Animal 3Animal 3 name(Required)Animal 3 species(Required)choose onecatdogDog - breed(Required)Animal 3 size(Required)choose one<5 - 10 lbs11 - 20 lbs21 - 30 lbs31 - 40 lbs41 - 50 lbs51 + lbsAnimal 3 color(Required)Animal 3 gender(Required)choose onefemalemaleHas the animal 3 been spayed?(Required)choose onenoyesHas animal 3 been neutered?(Required)choose onenoyesHas animal 3 ever bitten anybody?(Required)choose onenoyesAnimal 3 age(Required)choose oneunder 4 weeks4 - 8 weeks2 - 3 months4 - 8 months9 - 12 months1 - 2 years3 - 5 years5 years +Does animal 3 have any medical issues including allergies or special dietary needs?(Required)choose onenoyesAnimal 3 explain medical issues.What food (brand and type) does animal 3 usually eat?(Required)Animal 3 personality(Required) good with dogs good with cats good with small animals good with small children good with Men good with Women crate trained house broken Food Aggressive Shy Friendly Protective Playful Easy Going none of the above How long have you had animal 3?(Required) less than 6 months less than a year 2 - 4 years 5 - 8 years over 8 years Where did you get animal 3?(Required) friend pet shop breeder stray an animal shelter Name and location of animal shelter where you got animal 3.(Required)Is animal 3 mostly(Required) an indoor pet an outdoor pet both indoor and outdoor When out doors, is animal 3 mostly:(Required) fenced in yard kennelled leash walked out on a lead or rope kept with an invisible fence When alone, is animal 3 mostly(Required) outdoors in a fenced area free in the house confined to a room in the garage crated Animal 3 photo Drop files here or Select files Max. file size: 80 MB. Just a few more questions...Reason(s) for surrender - click all that apply.(Required) allergies behavior citations cost of food cost of vet care have too many pets insurance moving conflict with others pending eviction homeless no time for care no longer want animal other reason (please enter below) Other reason not listedIf moving, why can't pet(s) go?If puppies or kittens, is the mother also being surrendered?choose oneno puppies or kittensnoyesYou will schedule your appointment(s) after you submit this form.Are you ready to submit the completed form and set your appointment(s) for surrender?Pull down to select yes.Yes, I am ready to submit this form now.NameThis field is for validation purposes and should be left unchanged.
