Dog Surrender

Dog Owner Surrender Form

Please Read Carefully

Forms which all questions are not answered will not be added to the list and you will not be contacted. We unfortunately do not have the time to follow up and gather this information and all questions have been added for a reason.

Please note that we will call you in due course to go through your application once it is received. You will receive a call from 01 4994710 please save this to your phone and if you receive a missed call please call us back ASAP.

We unfortunately cannot hold kennels for people we find it difficult to get in touch with. Our main priority is the sick and injured so please be patient in waiting to hear from us – it may be a few weeks before you receive a call. There will a surrender donation to go towards the care of your dog while at DSPCA.

Note: fields with * are mandatory

Personal Details

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region Eircode Country

Phone(Required)

Dog Details

Dog's Name(Required)

Breed * (Please do not put Mixed breed give a rough guide of what breed)(Required)

Age(Required)

Gender(Required)

Neutered? (If NO, a fee of €60 will apply)(Required)

Is your dog up to date with vaccinations?(Required)

If NO please contact a vet ASAP to have this booked as your dog must be vaccinated to come into the shelter, NO EXCEPTIONS. If you cannot afford a vet, please visit our Mobile Vet clinic to have your dog vaccinated.

Please Upload a photo of your dog's vaccination card.(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.

Last deflead Date:(Required)

Last dewormed Date:(Required)

Is your dog microchipped? * (If NO a fee of €25 will apply)(Required)

Has your dog any Illness, Injuries, Surgery, Insurance:(Required)

If yes, please give details.

Reason For Surrendering Your Dog

Please be honest. Upon surrendering your dog to the shelter there will be a behaviour assessment, if you have not been honest we may refuse to take your dog

Reason(Required)

Has your dog ever shown any signs of Aggression?(Required)

If yes you must provide details. If left unanswered you will not receive a call.(Required)

Is your dog(s) ok with vets?(Required)

Has your dog(s) ever bitten a person?(Required)

Is your dog(s) good with other dogs?(Required)

Did your dog(s) live in a home with children? *

If yes, please provide ages(Required)

Provide ages of any visiting children to the home

Have you ever attended dog training classes with your dog?(Required)

If yes, please provide trainer's name.(Required)

Where does your dog sleep at night?(Required)

Name of your vet(Required)

Phone number of vet(Required)

Date of Last Visit(Required)

More About Dog(Required)

Please provide as much information as possible, being completely honest in order for us to place your dog in the correct home. Add details on your dog’s likes / dislikes / personality / temperament / travels well etc.

Your Name(Required)

I agree that all the information I have provided above is true and correct.(Required)

Yes