Pet Surrender Application - Other Pets

Thank you for reaching out to us to help rehome your pet.

Please complete the form below, providing as much detail as possible about you, your pet, and your circumstances. The information you provide will help us to assess your application, and will also help in rehoming your pet by providing information to their new owner.

Once you submit your form, a member of our team will be in touch to discuss your application further.

(If you need to surrender more than one animal, please complete a separate form for each animal).

About You

Your first name (required)

Your last name (required)

Your address (please include suburb and post code) (required)

Your phone (required)

Your email (required)

Your date of birth (required)

Your drivers licence number (please indicate state, if not WA) (required)

Why do you need to surrender your pet? (required)

About Your Pet’s Health

Does this pet have any medical conditions? (required)

YesNo

If Yes, please provide details (e.g. itchy skin, allergies, arthritis, etc.)

Is this pet currently receiving any medical treatment or medications? (required)

YesNo

If Yes, please provide details (e.g. name and type of medication, dosage, etc.)

Name of usual vet (required)

Vet’s phone number (required)

What type of food does your pet eat? (Please include brand names, quantities and feeding frequency). (required)

About Your Pet’s Behaviour

Is this pet aggressive towards people? (required)

YesNoNot sure

Is this pet aggressive towards other animals? (required)

YesNoNot sure

If you answered Yes to EITHER of the above questions, please provide details (e.g. circumstances of this behaviour, frequency, severity of injury to people, other animals or your pet, whether medical treatment or veterinary treatment was needed, etc.)

Is there any other information about your pet that you’d like to share or pass on to their potential new family? (e.g. what kind of toys do they like? Do they have a favourite trick? Do they like being handled? etc.) (required)

Declaration

Please choose ONE from the following: (required)

As the sole legal and beneficial owner of the animal described above, I declare that: 1) I surrender as the sole legal and beneficial owner, the animal free of any third party; 2) I surrender all my rights, titles and interest in the animal to RSPCA WA and in doing so I understand that the animal will become the sole and absolute property of RSPCA WA; 3) I agree to indemnify RSPCA WA and keep RSPCA WA so indemnified against all claims (if any), costs and expenses whatsoever arising out of any action by any person claiming an interest in the animal; 4) I am 18 years of age or olderThe animal is not owned by me, I am not aware of the animal’s true owner and I have made all reasonable efforts to identify the owner, therefore I believe the animal to be a stray.The animal has been abandoned by a third party at a property owned or controlled by me.

Next Steps

Once you submit this form, it will be sent to the Shelter team. Once they assess your application, they will contact you on the number you have provided above to discuss your application in further detail. This should take around 3 business days.

In the meantime, please contact your vet and request a medical history of your pet. They can either send it to you, or they can send it directly to [email protected].

Again, thank you for reaching out for help with your pet.