Coastal German Shepherd Rescue
Owner Surrender

Please Read through the following information carefully before submitting your request!

Thank you for contacting Coastal German Shepherd Rescue. As we strongly discourage people giving up their dogs under most situations and as our primary focus is pulling dogs from kill shelters, we have slightly stringent owner surrender guidelines. After the below items are met, each owner surrendered dog will be reviewed by the board based on space and budget considerations prior to acceptance into our program.

* IF YOU HAVE ADOPTED YOUR DOG THROUGH COASTAL GERMAN SHEPHERD RESCUE AND NEED TO RETURN HIM/HER TO US, PLEASE CONTACT THE ADOPTION COUNSELOR DESIGNATED ON YOUR CONTRACT. Please provide the dog's name, tag number, and reason for reliquishmentment in your email. Current Photos, short bio, and your current contact information are appreciated as well.

Initial steps to request your dog's acceptance into Coastal GSR are generally as follows:

  1. Submit our online owner surrender form. This has a lot of the information we need about your dog as we consider his/her acceptance into our program and future placement.
  2. In most cases, we require that the dog be up to date on vaccinations, have a history of being kept on heartworm preventative, and spayed/neutered and that you be able to supply proof through your veterinarian of the above items. Generally, you, the owner, will have to address the items that are not current prior to our acceptance of the dog.
  3. The dog will need to be taken to one of our volunteers for a personality evaluation. Note that we are unable to accept dogs that have ever shown aggression toward humans.
  4. Much of the decision to accept a dog into our program is based on foster space and funds. If you are able to foster the dog until a new home can be found, this greatly increases your dog's chance of acceptance into the program. If you are not able to foster and your pet is approved by the board, we request a MONETARY donation to go toward the food and VETERINARY CARE that your dog will require while with us. These items are expensive, and we would request that you be as generous as possible when donating toward the foster care of your dog.
  5. Coastal GSR will acquire, by assignment documentation, the property rights to your dog, including the right to place the dog into a new home. You will not have any right to know where the dog is placed, nor will you have a right to any adoption donation made to Coastal GSR.

Owner Relinquishment

Please answer the questions honestly and be as detailed as possible.  This will help is in determining if we will be able to accept your dog in to our rescue.  

Please note that shelter dogs in need will take precedence over any owner surrendered dog.*  Due to the lack of foster home, in most cases, you will be required to "foster" your dog until a home can be found.

This information MUST be submitted along with a photograph before we will consider accepting your dog in to our program. Upon completing the below information, IMMEDIATELY email a picture of your dog to  No further action is required.  As a 100% volunteer organization, we will contact you as soon as possible, usually within 48 hours.



Owner Information

* denotes a required field

Name: *

Address: *

City: *

State: *

Zip Code: *

E-mail: *                  

Phone: *

Evening Phone Number:

Mobile Phone Number:

Best time to contact you:  

Dog Information

Dog's Name:

AKC Name:                

AKC Number:

Date of Birth:

How Originally Acquired Dog: 

When Acquired:

If from a Breeder, have you contacted them?

Why do you need to rehome your German Shepherd?

When does dog have to leave your home?

Are you willing to foster the dog after legally relinquishing the dog to us until a permanent home can be found?

Dog's Physical Appearance




Height:   Weight:


Micro Chip (Make & Number):

Scars, Broken Teeth, etc.:

General overall appearance:                            

Personality Traits
(please check all that apply)


Dogs   Cats    Other Small Animals    Children    Strangers   Visits to Vet:  

Crates   Car Rides   Toys/Play   Water   Being Groomed   Traveling   

Running/Jogging  Likes Walks


Dog Aggression   Food Aggression    Toy Aggression    Fence Jumping    Escapes Yard

Digging     Separation Anxiety    Chewing  Barking when left unattended    Destructive

Scared of Thunderstorms 

Other Fears/Dislikes:

Other Aggressions:

Temperament Toward People

Friendly    Shy    Cautious    Outgoing      Hyper    Energetic    Calm

Anxious    Dominant    Submissive    Submissive Peeing   Obedient    Challenging   

Temperament Towards Other Dogs

Friendly    Shy    Cautious Outgoing    Hyper    Energetic    Calm   

Anxious    DominantSubmissive    Obedient    Challenging

Has dog ever bitten a human?  If yes describe situation, location, when, seriousness of bite, etc.

Has dog ever nipped/shown aggression towards a human?  If yes describe situation, location, when, etc.

Types of Training this dog has had:

Is the dog crate trained:

Describe any behavioral problems you have experienced.

I would consider this dog to have a energy level.

Dog's History and Experiences

   House dog     Housebroken    Outdoor Dog    Tied Up    Contained in Open Yard     

   Sleeps Inside    Sleeps Outside     Sleeps in the Garage

Has this dog ever been:

Abused    Neglected in any way    Hit by a car    Bred    Allowed on Furniture

Allowed to run off-leash in a NON-fenced in area    Attacked by another animal   

Kenneled   Used to wearing a collar   

How does this dog signal to go outside:

What words or commands does this dog know:

Medical History

We request you provide Coastal GSR with copies of the dog's entire medical history file if possible when your dog is accepted in to our care.

Veterinarian Name:


City, State, Zip:                   


Date of Last Visit for this dog:

Vaccination History 
(dates last received)

We encourage owners to have their dog current on all vaccines, be spayed/neutered PRIOR to acceptance.

DHPP:    Rabies: Bordetella:

Date of HEARTWORM Test:             Results:

Currently on Preventative:   What Brand:



Medical Problems:

Medications Required:


Ever Required Emergency Care:

Current Dog Food:

Current Feeding Schedule & Quantity:

Any other information that may facilitate us in finding a new home for your dog?

Items You Are Sending with the Dog

Toys    Crate/Bed    Food    Collar w/tags    Leash    Medication


Please be advised we will want to speak with your veterinarian. Please contact your veterinarian to let him/her know we will be calling and that you authorize him/her and/or their representatives to release all records of your dog to us.

 By submitting this form, I hereby swear that the above information is true and complete to the best of my knowledge and ability about the above said dog.  I understand that the dog will be further evaluated by Coastal GSR to determine whether or not it is adoptable.  All information related to temperament (especially biting incidents) have been disclosed above.

 Type in your name:

Today's Date:

We reserve the right to refuse or deny any application