Equine Surrender Request Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Phone *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAre you able to transport? *YesNoWhere is the animal located? (exact physical location for pickup) *Physical location of the animal. Could be coordinates, Google maps link, something we can use to find the horse if we need to pick him/her up.Are you able to cover the cost of transport? *YesNoAnimal Type *HorseDonkeyMuleOtherAnimal Name *Gender *FemaleMaleUnknownIs he a gelding or stallion? *GeldingStallionIs it possible she could be pregnant? *YesNoHas she ever been bred? *YesNoUnsureYear of birth (if not known, approximate) *Breed *Height *Registration Number if applicablePlease provide any registration papers at the time of surrenderColour and markings *Is this equine rideable? *YesNoUnsureHas this equine ever received any professional training? *YesNoUnsurePlease detail any training, experience, riding discipline details hereHas this equine ever injured anyone? *YesNoUnsurePlease explain the circumstances *Does this equine have any habits that may create harm to other horses or people or cause damage to the facility? *YesNo(i.e. kicks, bites, rears, bucks, cribs, etc.)Please detail the issues *Reason for surrender *Is this equine sick or injured?YesNoIf sick or injured, please detailHas this equine been exposed to any contagions or displayed any symptoms within the last 45 days? *YesNoUnsurePlease details the symptoms and/or exposure *Does this equine have a current coggins test? *YesNoUnsureIf yes, please have the coggins test results when surrendering the equine.Does this equine have any conditions restricting it's feed, bedding, turnout or any other care or maintenance? *YesNoUnsure(i.e. founder, EPM, allergies, etc.)Please explain the conditions and restrictions required *Is this equine accustomed to pasture turnout? *YesNoUnsureCan this equine be turned out with a herd? *YesNoUnsureDoes this equine act aggressively with any other breed, gender or age of equine in a herd? *YesNoUnsurePlease explain what causes aggression in this equine *Does this equine stand well for veterinarian and farrier? *YesNoUnsureDoes this equine lead well with a halter and lead rope? *YesNoUnsureDoes this equine load and trailer well? *YesNoUnsureAny other known history you would like to sharePlease provide vaccination / care dates:Please have vaccination records ready to surrender with the equine.EncephalomyelitisTetanusRhino-FluRabiesWest Nile VirusWormingHoof CareDental CareRequired Vet ServicesRegular VaccinationsDewormingCoggins TestLice/Mite TreatmentMedical CareRabies VaccineAnimal Image Click or drag a file to this area to upload.Do you certify that all information provided on this form is true and accurate?YesNoSubmit
