Every animal deserves a chance

Surrender a Pet

We understand that surrendering a pet is a difficult decision. Our goal is to keep your pet safe, healthy, and find them the best possible future. The more we know, the better we can help.

Before you fill this out

A few things to know

Talk to us first

Sometimes a conversation solves the problem: behavior tips, low-cost care, or help finding a new home yourself. Call (913) 367-3647 during open hours.

This form is a request

Space at the shelter changes daily, so we schedule intakes rather than accept walk-ins. We'll contact you to talk through timing and what to bring.

Emergencies

If an animal is in immediate danger, injured, or you've found a stray, call us or the Atchison Police non-emergency line rather than waiting on this form.

Animal surrender form

Tell us about your pet

Fill out as much as you can. Fields marked are required.

Your information

Name

Phone

Email (optional — we'll send a confirmation)

Address

City / State / ZIP

I would like to remain anonymous (if possible)

About the animal

Type of animal 🐶 Dog 🐱 Cat 🐾 Other

Name (if known)

Age (approximate)

Sex Male Female Unknown

Spayed / neutered? Yes No Unknown

Breed / mix

Color / markings

Microchipped? Yes No Unknown

Where did you get this animal? Stray Found Breeder Previous owner Other

Health & medical history

Has your pet had any vaccinations? Yes No Unknown

Has your pet been on flea, tick, or heartworm prevention? Yes No Unknown

Does your pet have any known medical conditions? Yes No Unknown

Is your pet currently on any medication? Yes No Unknown

Behavior & temperament

Is your pet good with children? Yes No Unknown

Is your pet good with other dogs? Yes No Unknown

Is your pet good with cats? Yes No Unknown

Has your pet ever bitten anyone? Yes No Unknown

How would you describe your pet's personality? (check all that apply) Calm Energetic Shy Friendly Protective Other

Are there any triggers or behaviors we should know about?

Reason for surrender

Why do you need to surrender your pet? Housing issue Financial reasons Health reasons Behavior issues Allergies Moving Other

How soon do you need to surrender your pet? Immediately Within a few days Within a week Other

Is there anything else you would like us to know?

Please confirm

This form is a request. The shelter will contact you to schedule an intake and cannot guarantee same-day space.
The information above is accurate to the best of my knowledge, so the shelter can care for the animal safely.

I understand and agree *

Questions or trouble with the form? Call (913) 367-3647 or email adoptions@humanesocietyofatchison.org.

Together we can give them a second chance.

Thank you for caring enough to plan your pet's next chapter instead of leaving it to chance.