Pet Surrender Request Form Please complete one form per animal(Litters can be submitted on a single form.)We’re a small, foster-based rescue, and while we do our best to help every animal, submitting this form does not guarantee we can take them in.If we aren’t able to accept your animal, we’ll share resources, shelters, and other rescues that may be able to help.A $25 surrender fee applies to each animal.By surrendering an animal, you acknowledge that ownership will be transferred to Iridescence Cares. First Name *Last Name *Email Address *Phone *CityState/ProvinceZIP / Postal CodeAnimal Information:Species *SelectCatDogOtherBreed (or best guess)Are you the owner of this animal? *SelectYesNoIf no, how did the animal come into your possession?How long have you had this animal?Are you able to transport the animal?SelectYesNoName of animalAge or Approximate AgeGenderSelectMaleFemaleSpayed/Neutered?SelectYesNoUnsureReason for Surrender:(be detailed)Upload PhotosFace, Full Body, Medical ConcernsChoose FileNo file chosenDelete uploaded fileHow does this animal behave with:Adults:Children:Cats:Dogs:Any history of:Biting humans?SelectYesNoUnsureAggression toward animals?SelectYesNoUnsureFearful or defensive behavior?SelectYesNoUnsureLitterbox/House Training Issues?SelectNoYesIf yes, please explain:If yes, please explain:Medical InformationVet name + approximate date of last visit:Does the animal have fleas/mites/URI symptoms currently? *If the animal has signs of URI, fleas, mange, or other contagious conditions, we must know ahead of time so we can plan appropriate isolation.SelectYesNoUnsureKnown medical conditions:Current medications:Is the animal vaccinated?SelectYesNoUnsureIf yes, provide dates if known:Are you able to pay the $25 surrender fee?SelectYesNoWhen are you hoping to surrender?Anything else we should know?Agreement *By submitting this form, I acknowledge: I understand this form does not guarantee acceptance. I agree to provide honest and complete information. If approved, I will bring the required surrender fee and any medical records. Upon surrender, ownership of the animal transfers fully to Iridescence Cares. Submit