DRUT Surrender Form

Thank you for considering giving your dachshund to the Dachshund Rescue of Utah (DRUT). Every situation is different and when you are considering giving a dachshund to DRUT it is often a difficult decision. We have a team of dedicated fosters that take the dogs in and make them part of their families, working with our vets to help them with their health after which point the dogs are available to be adopted.

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone *

Alternate phone

How did you hear about the Dacshund Rescue of Utah?

Animal’s name:

Type and size

Dachshund, chiweenie, mix, standard, tweenie, miniature, wire hair, smooth (short hair), long hair

Color:

For example: black and tan, red, brown, dapple, etc.

Sex: *

• Male
• Female

Approx. birth date (or Age):

Please provide a photo of your dog:

Click or drag files to this area to upload. You can upload up to 2 files.

The file type must be a .png or .jpg and 256MB or smaller.

Reason for surrender? *

About your dachshund?

• Spayed or Neutered?
• Crate trained?
• Good with car rides?
• House trained?
• Marks in house?
• Uses dog door
• Good walking on a leash?
• Bolts out open doors?
• Good with other dogs?
• Good with kids?
• Good with cats?
• Able to use stairs?
• Destructive?
• Possessive of toys?
• Separation anxiety?
• Fence climber/jumper?
• Digger?
• Barker?
• Knows: sit, down, stay, come?

Fears or aggression?

• Vet
• Children
• Thunder
• Hats
• Sunglasses
• Loud noises
• Men
• Other

If "other" or more details are needed please explain:

Vaccinations & Preventative

• Rabies
• DHLPP
• Bordatella
• Heartworm preventative

Energy Level?

Selected Value: 0

Values: 1 = Low (couch potato) ... 10 = High (hyper)

Other good or bad habits: *

Has your dog bitten anyone?

Medical problems or requirements:

Known illnesses or injuries?

Veterinarian *

Example: Name, Address, Phone Number (being able to access the dog's medical history is important.)

I certify that I am the owner of the animal described and I am relinquishing this animal to the Dachshund Rescue of Utah as of this date:

• Yes
• No

There is no exchange of funds for this dog.

Signature *

Clear Signature

Please sign here.

Submit