Request Pet Rehoming Assistance NEW Pet Re-Homing Request Form If you would like to have us help you locate the perfect family with whom to place your family member, please fill out this form. Please be sure to provide as much information about your pet as possible to help us create a meaningful profile to show our potential adoptive families Please note: If you need to rehome more than 1 pet, you can submit information for each additional pet here: Additional Pet Rehoming Form. Your Name First Last Address* Your Street Address City State Zip or Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands USA or Canada Email Enter Email Confirm Email If you live in a small town, please name any major cities that you are close to:CellBest Time To Reach You : HH MM AM PM What is the name of YOUR PET?* Best Photo of Your PetHere, please upload your favorite photo of your pet. This will be used as the featured image. You will be able to add many more photos and some video clips via Dropbox, a file storage service that we use. DON'T FORGET TO WAIT UNTIL THE LITTLE CIRCLE IS FINISHED LOADING YOUR PHOTO. SOMETIMES IT CAN TAKE A FEW MINUJTES, IF THE FILE IS MORE THAN 250 KB IN SIZE. If you have problems here, your image might be too large, or in the wrong format.. You can leave this blank and upload this photo to our DROPBOX service.Type of Pet*Is this pet a dog or cat?DogCatIf Other, Please Add Type of PetBreed of Pet*Secondary Breed of Pet (if known)Sex of Pet*Age of PetWeight (in pounds)Size*extra smallsmallmediumlargeextra large.Color of PetSecond ColorPet's Coat Type** This refers to whether your pet has a short coat, medium length coat or long coat.Spayed/Neutered? Yes No Up to date on vaccinations? Yes No Unknown Is pet microchipped or tattoed? Yes No Unknown ID / RegistryPlease provide your pet's microchip ID and information on whom the new owners will contact to transfer ownership information once a good home is found.Does this pet get along with cats? Yes No Unknown Does this pet get along with dogs? Yes No Unknown Is this pet good with children? Yes No Good With Children aged 8 and up Unknown Is this pet house broken or litter trained? Yes No Unknown (If dog) Is this pet crate-trained? Yes No Unknown Does Your Pet Have Any Health Problems? Yes No If yes, please provide details:Does Your Pet Have Any Behavior Problems? Yes No If yes, please provide details:Please Describe Your Pet's PersonalityPlease try to list 5 things that you love about your pet:What are your pet's favorite toys, foods, activities?If possible, please tell us a funny, cute or heartwarming story about your pet.For What Reason(s) are you needing to rehome your pet?Please describe what you are looking for in an adoptive family/home for your pet:What supplies and accessories will come with your pet?Do you hope or intend to stay in touch with your pet in it's new home? Yes No Unsure Additional Comments or InformationYouTube Video of Pet (optional) VETERINARY RECORDS (Optional - this information can be provided later, if desired) Please provide the name and contact information for your pets' veterinarian. This information will be needed by the new owners, so that they can have the records transfered to their veterinarian.Veterinarian Name: First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State PhoneEmail REHOMING SERVICES FEE The safety and effectiveness of our private pet rehoming services rely on our ability to pay for targeted advertising for your pet, and careful screening of potential owners. We ask for a reasonable one-time intake fee to rehome each pet, which gives us a fund from which to pay for these expenses.If you are a senior, disabled or otherwise in a situation of financial distress, just let us know and we will do our very best to help you out. At the very least, a small non-refundable donation of $35 will be required, along with your commitment to working with us to rehome your pet. Please note: If you would like to speak with one of our pet rehoming coordinators before paying this fee, please select "I will submit fees after consultation", from the drop down menu below. If you are only in need of assistance locating a home for your pet, but would prefer to skip our extensive screening/placement guidance services and rehoming guarantee, please choose the "basic" service option. Questions? Feel free to call (888) 720-3322 or email petrehomingnetwork@gmail.comServices Required:* Please choose the pet rehoming package you require: Please indicate the services you require. Full details of our service packages can be found here. Full Rehoming Services - 150 Basic Rehoming Assistance - 75.00 Senior, Disabled, Military - 50.00 Financially Challenged 25.00 (Non-Refundable Donation By submitting this information and signing below, I hereby state that I am the owner of the pet referenced above, and that I authorize Pet Rehoming Network to provide private pet rehoming services on my behalf for the service fee detailed above, payable before services begin.Terms of Service*I hereby acknowledge that I have read and agree to the terms of service as set forth on this website. Yes No Your Signature Please Be Patient It may take up to 2 minutes for your information to be submitted to our rehoming team. Please check your email after submitting your information. You should receive email from our rehoming team with instructions for sending in photos/videos. Questions? You are welcome to call us toll free at (888) 720-3322. Our friendly and helpful team members are always happy to speak with you id