Small Mammal Surrender Questionnaire

Small Mammal Questionnaire

We understand that the decision to surrender a pet is not easy. We do our best to help every person that comes to us. Sometimes, there are better re-homing options, and we may recommend other resources, depending on your pet’s needs. Here is a link to other organizations in the area.

We are a private, non-profit, no-kill shelter with a 98% live release rate. We operate on an appointment-based schedule, and operate on a waitlist. Once a small mammal is adopted, we will contact you to get more information and discuss next steps. If you need immediate assistance, we recommend contacting your municipal shelter. If you are returning a pet within 2 weeks of adoption, we can usually offer an appointment within 48 hours of receiving this form.

We have a few questions that will help us assist you and your pet. Please be as detailed as possible when answering. Once we have received your questionnaire we will be in touch (usually by phone) to get more information and discuss next steps.

Your Name*

First Last

Your preferred name

Pronouns

he/him, she/her, they/them, ze/hir, etc.

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Are you the owner of this animal?*

Yes
No

Please provide full name and contact information of the owner

General Information

Why are you surrendering your animal?*

What efforts have you taken to re-home your animal?*

What is your timeline for surrendering*

Less than 1 week
1-2 weeks
2 weeks - 1 month
Greater than 1 month

Seattle Humane is usually scheduling 1-2 weeks in advance. If you need immediate assistance, please contact your municipal shelter.

Species*

Animal's Name*

Age*

please include units - i.e. years

Breed(s)*

Color(s)*

Sex*

Male
Female
Unsure

Spayed or neutered?*

Yes
No
Unsure

Is your pet microchipped?*

Yes
No
Unsure

Microchip number if known

History

How long have you had your pet?*

Please include units - i.e. years

Where did you get your pet?*

Ex: friend, craigslist, stray, breeder, pet store, etc

Has your pet seen a veterinarian?*

Yes
No
Unsure

Name of vet or clinic

We will contact your vet to obtain medical records. This helps us triage incoming animals and have a thorough picture of how to best serve you and your pet.

Phone number of vet or clinic

How is your pet around people he/she knows?*

Has your pet ever bitten a person?*

Yes
No

Please select yes if your pet has done this, even if they didn't break skin

Has your pet fought with, injured, or bitten another small mammal?*

Yes
No

Please select yes if your pet has done this, even if they didn't break skin

Does your pet have any current medical conditions?*

Yes
No
Unsure

Please explain any medical conditions

Has your pet ever had any of the following*

Check all that apply, even if not current

Optional: Upload a photo of your pet