Surrender application

General information

Name*

First Last

Street Address 1*

Street Address 2

City*

State*

If you would like to surrender a dog to Labrador Retriever Rescue, you must reside in ME, MA, NH, RI, or VT. Labs come into our program only from these states and may be adopted into homes only within this area. Please select your state from this drop-down menu.

Zip Code*

Phone Number*

Please fill in the best phone number where we can reach you.

Email*

Enter Email Confirm Email

Please tell us a little bit your Lab

What is the Lab's name?

What is the Lab's date of birth?*

How long have you owned this Lab?

How much does the Lab weigh?

What is the Lab's gender?

Male
Female

What is the Lab's color?

Black
Yellow
Chocolate

Has the Lab been spayed or neutered? (We do accept Labs who have not been spayed or neutered.)*

Yes
No

Is the Lab house-trained?*

Yes
No

Is the Lab crate-trained?*

Yes
No

Has the Lab had obedience training?*

Yes
No

Use this space to tell us why you are surrendering your dog.*

Please tell us about the Lab's origin

Is your dog a purebred Labrador Retriever?*

LRR accepts only purebred Labrador Retrievers.

Yes
No

Where did you get your Lab?

Have you contacted the breeder?*

Yes
No

Use this space to tell us anything else relevant about the dog's origin.

Please tell us about your Lab's daily life and temperament.

Where does the Lab spend the day?

Where does the Lab spend the night?

What commands does the dog know?

Describe the Lab's temperament.*

Describe the Lab's behavior with children under 5 years of age.*

Describe the Lab's behavior with children over 5 years of age.*

Does the dog like to swim?*

Yes
No

Has the dog ever growled, air-snapped, bitten, or lunged?*

Yes
No

What makes the Lab bark?

Does the dog have issues with dogs of the same gender, different gender, cats, or other animals?*

Yes
No

Is the dog bonded to another animal in the house?*

Yes
No

Does the dog exhibit separation anxiety?*

Yes
No

Use this space to tell us anything else about your dog's behavior or temperament that you think would be helpful in its placement.

Please tell us about your dog's health

Has the Lab been to the vet in the past 12 months?*

Yes
No

List any medical issues your dog has.

Does the Lab have difficulty climbing more than 4 stairs in a row or have other problems with stairs?

Yes
No

Is your Lab taking any medication other than a heartworm preventative?*

Yes
No

Is the Lab on a special diet or special food due to allergies or gastrointestinal issues?*

Yes
No

Has the Lab ever been diagnosed with or treated for cancer?*

Yes
No

Use this space to tell us anything else about your dog's health.

Have you contacted your vet's office and authorized them to share your Lab's medical information with LRR.*

Yes
No

Veterinarian's name

First Last

Veterinarian's Street Address 1*

Veterinarian's Street Address 2

Veterinarian's City*

Veterinarian's State*

Veterinarian's Zip Code*

Email

This field is for validation purposes and should be left unchanged.

Age	Donation
Less than 2 years	$500
2-6 years	$400
6-8 years	$350
9 and older	A good faith donation

General information

Please tell us a little bit your Lab

Please tell us about the Lab's origin

Please tell us about your Lab's daily life and temperament.

Please tell us about your dog's health

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