Surrendering Your Dog - WE are VERY limited on intake!
Surrendering your dog is a very serious decision....  So, please make sure you have considered every option before
contacting a rescue organization.  Submitting a surrender request is ONLY a request!  SSTR is limited by lack of funding and
foster room, so we may be unable to assist in rehoming  your dog.

If you have any questions about SSTR or our adoption screening process,
we suggest you read our ADOPTION INFORMATION and ABOUT US Info, listed on our website.

SSTR requires all owner surrenders to be CURRENT on vaccinations, neutered/spayed and heartworm tested.  If you
cannot provide this information a $100.00/dog donation will be requested to offset vet care expenses.  If you are unable
to make this donation, please submit form anyway, we may have a sponsor that will help with your dogs vet care.

WE ARE CURRENTLY UNABLE TO TAKE ANY DOGS THAT HAVE A HISTORY OF AGGRESSION / BITTING!  
Due to lack of room and adoption interest in dogs with this history, our sanctuary program is FULL -
Owner Name
Street Address
City, State & Zip
Email
Work Phone
Home Phone
Does this dog belong
to you?  If not, please
explain.... and submit
request for rescue
assistance!
Dog's Name
Sex
Age and Weight
Breed and Color
Vet's Name
Vet's Phone Number
Date of Current Shots
Yes
 No
Unknown
Has dog been tested
for heart worms?
Is the dog on heart
worm preventative?
 Yes
 Unknown
No
Yes
No
 Unknown
Is this dog altered?
(Spayed/Neutered)    
Is the dog
house-trained?
 Yes
Unknown
No
All
dogs
 Small
dogs
 Male dogs
only
is the dog good with
(check all that apply)
Female
dogs
only
Unknown
Is the dog good with
children?
 Yes
 Unknown
No
List any known habits
the dog has:
Has the dog ever bitten
a person or another
animal? If so, please give
details:
Does the dog have any
known allergies or
medical conditions?:
Reason this dog is
being surrendered?:
If you are not located in
AL have you contacted
a rescue in your state?
If so, what group and
what was the result?:
I certify that the information provided on this form is true & correct.  By submitting this
request for owner surrender you acknowledge that you are aware once SSTR takes
possession of your pet, you will not longer have any rights of ownership and can NOT
reclaim your pet for any reason!   If we accept your dog in to rescue, ONCE taken in
possession by a SSTR representative, this submission form will constitute
as your legal relinquishment of ownership and ALL RIGHTS to this dog.
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Southern Shih Tzu & Toy Breed
Rescue and Sanctuary
A 501c 3 Non-Profit charity located in central Alabama and southern Louisiana,  dedicated to rescuing, rehoming and
providing sanctuary care for abandoned, abused and homeless toy breeds. Focusing on shelter dogs and breeder/mill dogs.