Request to Surrender - TSCA Rescue & Health Trust

Tibetan Spaniel Rescue Request to Surrender

TSCA Rescue finds loving homes for Tibetan Spaniels whose owners relinquish ownership and surrender them into our care for re-homing. If the owner is deceased or incapable, a representative (such as the owner's heir) may surrender the Tibbie. The reasons for surrendering a Tibbie generally involve hardship.

We understand that surrender is a difficult, often heart-breaking decision. We urge you to think carefully about what is best for the Tibbie. Sometimes, problems that seem insurmountable may have doable solutions other than surrender. However, if you decide to go forward with surrender, we will put all our effort into finding the best furever home possible.

The first step is to complete the Request to Surrender form. The main purpose of the form is to gather information about the Tibbie to help us find the perfect match. It's a long form, with lots of questions. Please be patient and give thought to each question as you answer. We rely on you to give us as much info about the Tibbie as possible; the more info, the better the match we can make. In addition to submitting the form, we will ask you to send us photos and other types of records about the Tibbie.

If you need to stop before completing the Request, scroll to the end where you will find a Save and Continue button. When you press the Save and Continue button, you will receive a link so that you can return to your Request later. You can also opt to have the link sent to you by email.

When you have finished answering all the questions, press the Submit button to send the form to us. If you missed a required question(s), you'll receive an error message. Scroll down through the form to find the errors in red. After correcting the errors, you must re-submit the form. If you made no errors, you'll see a confirmation message.

If you need help, you can reach us at info@tstrust.org.

After reviewing the form, a Coordinator will contact you to discuss your answers and make arrangements. For more information about the surrender process, please see our Surrender page.

Description

These questions are a general physical description of the Tibbie to be surrendered.

Name of Tibbie:(Required)

Gender (check one):(Required)

Male

Female

Is he neutered?(Required)

Yes

Is she spayed?(Required)

Yes

Don't know

How old is the Tibbie?(Required)

If you don't know, please estimate.

Do you know the date of birth?(Required)

Yes

Date of Birth:(Required)

Color:(Required)

Weight:(Required)

If you don't know, please estimate.

Why is this Tibbie being surrendered?(Required)

Please be as specific as possible about the reasons.

Are Tibbies other than the one named above being surrendered?(Required)

Please submit one Request per Tibbie being surrendered.

Yes, one or more other Tibbies are being surrendered.

No, this is the only Tibbie being surrendered.

Information about Owner

These questions are about the Tibbie's legal owner and, if different, the person completing this Request form.

Are you (the person completing this form) the legal owner of the Tibbie named above?(Required)

Yes

Your Name(s):(Required)

This is the name of the person completing this form if not the owner.

What is your relationship to the legal owner?

Why are you completing this form on the owner's behalf?(Required)

Your Email:

We need the contact info for the person completing this form if not the owner.

Your Cell Phone:

Owner's Name:(Required)

If there is more than one owner (e.g., co-owner), list all.

Is the owner(s) living?(Required)

Yes

Owner's Email:(Required)

We need the contact info for the legal owner of the Tibbie. If the owner does not have an email, enter "none."

Owner's Cell Phone:(Required)

If the owner doesn't have a phone, skip this question.

Tibbie's Location Address:(Required)

We need to know where the Tibbie is actually living.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is the address above the owner's address?(Required)

Yes, the Tibbie is living at the owner's address.

No, the Tibbie is not living with the owner.

Who is the Tibbie living with?(Required)

We need to know who has custody of the Tibbie.

Where was this Tibbie acquired?(Required)

Breeder

Other

Don't know

Breeder (name, city/state, contact):(Required)

Please provide any information known about the breeder, even if incomplete.

Other(Required)

Please provide any details known about where the Tibbie came from and when. For example, if the Tibbie came from a shelter, enter "Shelter," the name or location of the shelter (if known) and the year the Tibbie was adopted.

Behavior

Detailed, accurate answers to these questions are critical to finding the right home for the Tibbie. We do not exclude Tibbies based on these answers.

Has this Tibbie ever bitten or injured a person or another animal?(Required)

Telling us about a bite or other injury does not preclude our taking in the Tibbie. However, it gives us information that will allow us to place the dog in the best possible home. Failure to disclose a dog's bite history, if any, may cause you to be legally liable for future damages.

Yes

It is important for us to understand the type and extent of injury, the level of aggression and what may have caused it.

Include the following information for each bite or injury:

What was the nature of the injury?

When did the bite/injury happen?

Who was injured? If a person, what was the age of the person? If an animal, what kind of animal?

What was happening just before the injury, if you know? For example, "The child tripped and fell on the dog, and the dog turned and bit her in the face." Or, "Our Lab was just walking by Mitzi and Mitzi jumped up and bit her."

How severe was the injury? If a bite, did it break or bruise the skin? Was medical care required for the injury?

Was the Tibbie required to be quarantined as a result of the bite?

Please describe the circumstances fully:(Required)

Tell us about the Tibbie's temperament:(Required)

For example, is the Tibbie active or a couch potato, quiet or barky, independent or obedient, timid or friendly?

Is the Tibbie reliably housetrained?(Required)

Yes

Describe the Tibbie's habits for doing his business.(Required)

Include whether he "signals" to go out and his "potty" schedule (what times he's used to going, where and how long). Also, please describe any problems (such as "marking" in the house).

When is the Tibbie fed?(Required)

Both AM and PM

Free feeding (food is always available)

Food Type:(Required)

Canned

Dry

Fresh

Other (e.g., home-cooked, raw, etc.)

How much is the Tibbie fed per meal?

Brand Name and Variety/Flavor of Food:

For example, "Hill's Senior Diet, turkey flavor"

Where does he sleep?(Required)

How and where does he spend his day?(Required)

For example, "He stays in the kitchen while I'm at work, has free run of house when I'm home. We go for a walk before I leave for work and before bedtime."

What are his most favorite things?(Required)

For example, "He loves his lamb toy and going for rides"

What does he fear or dislike?(Required)

For example, "Thunderstorms, fireworks, nail trimming"

Does he have any bad or unusual habits?(Required)

Yes

Please describe the bad habits fully:

For example, "charging the front door when I open it," "won't stop barking," "steals and eats toilet paper."

Has he had any training, either formal or informal?(Required)

Yes

Please describe the training:

For example, "He went to a puppy class." " I taught him sit, stay and come."

Tell us how the Tibbie reacts to each of the following. Please be specific.

If the Tibbie has never been exposed to any of these, just enter "unknown."

Reaction to Children:(Required)

Reaction to Strangers:(Required)

Reaction to Other Dogs:(Required)

Reaction to Cats:(Required)

Reaction to Other Animals:(Required)

For example, "scared of our horses," "almost caught our guinea pig when it got out of its cage," "hides when our parrot squawks"

Reaction to Being Left Alone:(Required)

Reaction to Being Groomed:(Required)

Reaction to Going to the Vet:(Required)

Reaction to Going for Car Rides:(Required)

Reaction to Being in a Crate or Carrier:(Required)

Reaction to Walking on a Leash:(Required)

Health Information

These are questions about the Tibbie's health history.

Veterinary Clinic/Hospital Name:(Required)

This is a veterinary practice that has recently cared for the Tibbie.

Veterinarian:

Veterinary Practice Address:

Street Address City State / Province / Region ZIP / Postal Code

Veterinarian Phone:(Required)

Is the Tibbie up to date on all vaccinations, including rabies?(Required)

Yes

Which vaccinations does the Tibbie need?

Is the Tibbie on heartworm preventative?(Required)

Yes

What kind and when was the last dose?

For example, "I give Heartgard on the first of each month."

Is the Tibbie on any medications?(Required)

Yes

Please list the medications and dosage:

For example, "Thyroid pill, once a day."

Do you have reason to believe that this Tibbie has ever been neglected or abused?(Required)

Yes

Please explain why you think he has been abused or neglected:

Check any of these health conditions that the Tibbie has (or has had in the past):(Required)

Ear infections or hearing problems

Eye or vision problems

Heart problems

Kidney problems

Skin or allergy problems

Other

None

For any health issue you checked above, please describe the condition (include approximate dates):(Required)

Surrender Arrangements

These questions help us determine the urgency of the surrender. A TSCA Rescue Coordinator will contact you to discuss the arrangements.

How soon do you want to surrender this Tibbie to TSCA Rescue?(Required)

Before we can accept surrender of a Tibbie into our care. we must arrange for a foster home and transport. A foster home may not be immediately available within a day's drive of the Tibbie's current location. Will the Tibbie be safe and cared for if he remains at his current location until a foster home is available?(Required)

Yes

Please explain the urgency of surrendering the Tibbie:

Transition to Adoptive Home

Transitioning from one home to another can be upsetting for Tibbies. Generally, the older the Tibbie the harder the transition. To cause the least amount of upset, we try to find a "foster-to-adopt" home whenever possible. That means that the Tibbie can move from the surrendering home directly to the new home that will adopt him.

Please describe what you think would be the best kind of adoptive home for this Tibbie:(Required)

For example, "quiet home with retired person," "other dogs to play with," "no young children," "yard to run and play in."

Photos

We need photos of your dog as soon as possible. We use them to confirm that your dog is a purebred Tibetan Spaniel. Later, we use them to find an adoptive home.

Please submit at least one recent photo that shows the dog's entire body, including the paws and tail. In addition, cute photos that show the dog's personality are very helpful.

If the photos are available for uploading, you may upload them now. If they are not available for uploading, please send them to us at info@tstrust.org immediately after submitting this form. Thanks!

If your photos are available to upload, please upload them here.

Drop files here or

Accepted file types: jpg, jpeg, png, Max. file size: 64 MB.

Records

It is important for us to obtain as many of the Tibbie's records as are available. The following questions are about various kinds of records.

Do you have veterinary records you can send us?(Required)

These would include vaccination records (types of vaccination and date last given), rabies certificates, heartworm tests, fecals, and so on.

Yes

Please contact the veterinary practice where this Tibbie is a patient. Ask them to mark the Tibbie's record that they have your permission to release the Tibbie's records to Tibetan Spaniel Rescue.

Is the Tibbie microchipped?(Required)

Yes

Don't know

Please enter the microchip manufacturer and number if you have it:

Microchip numbers may be found on veterinary records, such as rabies certificates, purchase records or a record from the microchip manufacturer or registration company.

If you didn't enter a microchip number above, please try to locate a record of it and either email us the number or a photo or scan of the record.

Do you have any ownership papers?(Required)

This includes American Kennel Club (AKC) or other registration certificates, sales contract, and so on.

Yes

Please email us a scan/photo of any papers you have.

Donations

Check any of the following items that you are willing to donate:(Required)

Donating the Tibbie's possessions, so that he will have familiar things around him, will ease the transition to his new home. These donations also help us contain costs.

Bed

Toys

Leash and collar/harness

Crate/carrier

Food/treats

Grooming supplies (such as shampoo, brush, comb)

Unused medications (such as heartworm preventative)

Other

None

Since you checked Other, please tell us what you plan to donate:

The TSCA RESCUE & HEALTH TRUST is a non-profit organization. We depend entirely on donations to pay veterinary bills and other expenses of rescue. Although we do not require a surrender fee, we would be grateful for any amount of donation to help us re-home your Tibbie and other Tibbies in need. You can donate online (PayPal) on our Donation page. Or, mail a check payable to ‘TSCA Rescue & Health Trust’ to:
TSCA Rescue & Health Trust
Linda Foiles
190 Cedar Valley Lane
Louisburg, NC 27549

Your Signature:(Required)

Enter (key) your name.

Signature Date:(Required)

Enter date you're submitting this Request.