ONLINE SURRENDER FORM

Please have some photos of your Boxer ready to email as prompted at end of submission to expedit the process. Thank You.

Due to the high volume of surrenders BRLA is not able to take agressive dogs or mixes at this time. Please consider all options for your pet

Your Name
Address
City/State/Zip
Phone #
E-Mail Address
Your Pet's Name
Your Pet's Breed
Your Pet's Coloring
Where did you acquire your pet?
How long have you had your pet?
Tail Docked? Yes No	Spayed or Neutered? Yes No
Good with dogs ? Yes No	Good with kids ? Yes No
Good with cats ? Yes No	Housebroken? Yes No
Ears Cropped? Yes No	Vaccinations Current? Yes No
Age of Pet	Your Pet's Health     Excellent Good Fair Poor
Has your Boxer visited Dog Parks or Doggie-Day Care? Please explain all medical conditions pet may have:
Please explain the reason for surrender:
Please specify necessary surrender date:

Comments:

How did you find out about BRLA? Friends or Family Search Engine Result Link on Other Boxer Site Link on Other Rescue Site Link on Other Pet Site Link on Other Website Just Surfing This test prevents automated submissions Enter the text that appears in above image: