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Owner/Keeper/Caretaker/Custodian Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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Surrender Information
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(enter approximate date if unknown)
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Medical History
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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If selected for residency, we will need copies of medical and vaccination records BEFORE the animal may join us at the Haven. If you already have that information available, please attach it below.

Please attach documents as a single PDF.
Terms & Conditions of Animal Surrender Application

I understand that Hercules' Haven will not pay to rescue an animal. I also understand that Hercules' Haven gives priority to admissions for farm animals referred by local shelters, partner rescues, and to rescue animals from industrial farms. I accept that my submission of this application is in no way a confirmation that my animal will be accepted as a new resident of Hercules' Haven. I agree to respect the intake decision made by the Haven’s Executive Committee as being the best decision for my animal and Hercules' Haven.

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