To download a printable copy of this owner release form, click the Download button below. 

Due to the vast number of owner released animals being brought to H.A.R.T., we are no longer able to accept owner released animals without receiving a donation to help us toward the cost of caring for the animal while we are finding a perfect forever home for it. While in foster care, know that your animal will be excellently cared for, and receive any veterinary care that it needs. These needs can be costly, and we need your help to be able to provide that care for your animal. 

The required donation will be:

$50 if your pet is spayed/neutered and up to date on vaccinations. 

$100 if your pet is not spayed/neutered nor up to date on vaccinations.

Please understand that by asking for a donation for this service that we are providing, it allows us to help more animals and to continue dedicating ourselves to the ones that are dying in our local shelters. We are a non profit organization, run on donations and volunteers, and your donation enables us to continue our work. 

Thank you for your understanding.

Name *
Phone *
Spayed or Neutered? *
Sex *
What other types of pets did this dog live with?
Does this dog interact well with your other pets?
Is the dog housebroken? *
Have you ever consulted a trainer or behaviorist on any problems concerning this dog?
Has this dog ever bitten or snapped at anyone? *
Is this dog overly protective of
Has this ever created a problem?
Is this dog current on vaccinations? *
(Please provide vaccine records if possible)
Is this dog on a special diet? *
Do you accept the terms listed below? *

By hitting the submit button above you agree to all the terms.

I certify that I am the owner of this dog, free and clear of all other interests. I certify that this dog is not possessed of any dangerous or vicious propensities, and that I have not willfully concealed information about the dog that might indicate such propensities. The information I have provided about this dog is true and complete. I hereby forever release, discharge and agree to hold harmless and indemnify the rescue agency, its board of directors, its members, officers, and agents, from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of above named dog.