Surrender Statement By signing this surrender statement, all rights to ownership of the animal described are relinquished.  You will not be allowed to re-adopt this animal.  In signing, you authorize Silver Dragon Pets to make the final decision on the ultimate disposition of the animal, whether it is adoption, euthenasia, or transfer to another rescue. When considering adoptability through our program, we carefully examine health, temperament, and past and/or present behavioral problems.  If an animal is found to be in severe, untreatable pain, in the final stages of a terminal illness (cancer, organ failure, etc.), poses a danger to the humans caring for it, or has no quality of life, it will be euthenized.  Surrendering an animal to Silver Dragon Pets may put you on our "Do Not Adopt" file. I hereby surrender the below described animal, owned solely by me, to Silver Dragon Pets.   This animal, while in my custody, has not bitten anyone in the past 30 days.  I am supplying copies of all veterinary paperwork, including proof of current vaccinations.  If this pet has been surgically altered (spayed/neutered), I am including a spay/neuter certificate, or other proof the procedure has been completed.  I am also providing proof of a negative FIV/Feline Leukemia or heartowrm/lyme test dated no more than 60 days prior to date of surrender. I hereby acknowledge that the following information is true and I accept total responsibility for surrendering this animal.  If I am surrendering a cat or kitten, I understand that I have to have this pet FIV/Feline leukemia tested, at my expense, prior to surrendering it.  I understand that there is a surrender fee requested to help cover a portion of the veterinary and feeding costs of this animal. PLEASE PRINT Owner's Name: ________________________________________________________ Address: _____________________________________________________________ City: _______________________________ State: ___________  Zip: ______________ Phone: (___)___________________  Cell: (___)______________________ I am surrendering this pet because: __________________________________________ ________________________________________________________________________ ________________________________________________________________________ Veterinarian's Name: __________________________________ Veterinarian's Phone: (___)____________________ Name records are under: ____________________________________ Medical Problems Past/Present: ______________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ I got this pet from: __________________________________________________________ I've had this pet for (how long): _______________________________________________ Microchip or Tattoo number and location: ________________________________________ Do you want your name and phone number released to the new owner adopting this pet? ______ **This form is REQUIRED for all surrenders!