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JCHS Animal Surrender Request Form

Are you considering finding a new home for your pet? 

 

We recognize that unforeseen circumstances can arise, making it challenging to provide the care your pet needs. Our primary concern is to prevent anyone from feeling so burdened

that they resort to giving their pet to an unknown individual. 

 

We are committed to ensuring that your cherished companion is placed in a nurturing environment where they will be loved.

 

Jefferson County Humane Society in Valley Falls, Kansas, is a No-Kill shelter that supports all animals, regardless of their disabilities, injuries, age, or health issues. 

 

Before you proceed with a surrender request,

please be certain about your decision to rehome your beloved pet. 

 

Upon receiving your surrender request, we will carefully evaluate your submission, and a someone will reach out to you via email or phone as soon as possible.

Owner Surrender Request Form

What Species is your pet?
Is this animal Spayed or Neutered?
Is this animal Female or Male?
Where has this animal lived ?
Is this animal House Trained?
Does this animal have special needs?
Does this animal require medications regularly?
Is this animal up-to-date on vaccinations?
Has this animal been around kids?
Yes
No
Has this animal been around cats?
Yes
No
Has this animal been around dogs?
Yes
No
Has this animal ever bitten anyone?
Yes
No
Has this animal attacked another animal?
Yes
No
If you are surrendering a dog, please ensure you have completed a behavioral evaluation prior to intake. Should the dog exhibit any signs of aggression, we regret to inform you that, for safety reasons, we will be unable to accept the animal.
Yes
No

15295 K4 Highway, Valley Falls, Kansas 66088

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