Gulf Coast Humane Society
Home
About
About Us
Blog
Board of Directors
FAQs
Financials
Job Opportunities
Media
Meet The Team
Rescue Partners
(239) 332 0364
Stay Connected
Adopt
Adopt
Adoptable Cats
Adoptable Dogs
Dolly’s Dream
(239) 332 0364
Stay Connected
Contact
Events
Give
Way To Give
Legacy Planning
Lifetime Pack Leader Club
Okan’s Fund
Pack Leader Club
Pet Food Pantry
Recurring Donation Program
Second Chance Fund
Spay It Forward
Supplies Wish List
(239) 332 0364
Stay Connected
Medical Clinics
Our Clinics
Spay & Neuter Clinic
Veterinary Wellness Clinic
Online Pharmacy
(239) 332 0364
Stay Connected
Resources
Pet Resources
Dog Obedience Workshops
Pet Food Pantry
Pet Legacy Program
Stop Dog Fighting SWFL
Surrendering Your Pet
(239) 332 0364
Stay Connected
Volunteer
Volunteer / Events
Volunteer Application and Opportunities
Foster Program
Community Service
Senior to Senior Program
Trap-Neuter-Return
What Our Volunteers Say
(239) 332 0364
Stay Connected
Donate Now
Home
About
About Us
Blog
Board of Directors
FAQs
Financials
Job Opportunities
Media
Meet The Team
Rescue Partners
(239) 332 0364
Stay Connected
Adopt
Adopt
Adoptable Cats
Adoptable Dogs
Dolly’s Dream
(239) 332 0364
Stay Connected
Contact
Events
Give
Way To Give
Legacy Planning
Lifetime Pack Leader Club
Okan’s Fund
Pack Leader Club
Pet Food Pantry
Recurring Donation Program
Second Chance Fund
Spay It Forward
Supplies Wish List
(239) 332 0364
Stay Connected
Medical Clinics
Our Clinics
Spay & Neuter Clinic
Veterinary Wellness Clinic
Online Pharmacy
(239) 332 0364
Stay Connected
Resources
Pet Resources
Dog Obedience Workshops
Pet Food Pantry
Pet Legacy Program
Stop Dog Fighting SWFL
Surrendering Your Pet
(239) 332 0364
Stay Connected
Volunteer
Volunteer / Events
Volunteer Application and Opportunities
Foster Program
Community Service
Senior to Senior Program
Trap-Neuter-Return
What Our Volunteers Say
(239) 332 0364
Stay Connected
Donate Now
« All Events
This event has passed.
Meet and Greet With Darcy Andrade
June 29 @ 9:00 am
-
11:00 am
«
Meet and Greet With Darcy Andrade
Pics For Paws – A Third Party Fundraising Event
»
Add to calendar
Google Calendar
iCalendar
Outlook 365
Outlook Live
Details
Date:
June 29
Time:
9:00 am - 11:00 am
Event Category:
Community
Website:
meet-and-greet-june-29
Venue
GCHS Acoptions
2010 Arcadia St
Fort Myers
,
33916
United States
+ Google Map
Phone
2393320364
Cat Adoption Special
CLOSE
Owner Surrender Form
PET INTAKE FORM
First Name
(Required)
Last Name
(Required)
Phone
(Required)
Email
(Required)
Address
(Required)
City
(Required)
State
(Required)
Zip
(Required)
Date
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Pet’s Name
(Required)
Pet Type
(Required)
Dog
Cat
Pocket Pe
Breed
(Required)
Approximate Weight:
(Required)
Color
(Required)
Age / D.O.B
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Sex
(Required)
Fixed
(Required)
Microchip
(Required)
Up to date on vaccines?
(Required)
Yes
No
(Attach vaccine records)
File
Max. file size: 50 MB.
Vet Name:
Vet Phone Number:
Why are you surrendering your pet?
(Required)
Where did you acquire your pet?
(Required)
How long have you had your pet?
(Required)
Is your animal current on Heart-worm/Flea Prevention? If so, list below and attach medical records
(Required)
Yes
No
Other
When last given
File
Max. file size: 50 MB.
Does your pet have any current or past health conditions or injuries? If so-list below and attach medical records
(Required)
File
Max. file size: 50 MB.
Who does your pet get along with?
(Required)
MEN
WOMEN
CHILDREN (1-3 years)
CHILDREN (4-7 years)
CHILDREN (8-11 + years)
DOGS
CATS
Select All
Has your pet ever shown signs of aggression?
(Required)
Yes
No
If yes, was it provoked? Please explain
Does your pet live Indoors, Outdoors or both
(Required)
What type of food does your pet eat?
(Required)
Any destructive habits?
(Required)
Yes
No
If yes, explain
Is your pet house broken / Litter trained?
(Required)
Yes
No
Obedience training?
(Required)
Yes
No
Please tell us about your pet and any special characteristic personality traits, or special needs:
(Required)
STATEMENT OF SURRENDER
I certify that I
(Required)
Do own the animal described above
Do NOT own the animal described above
I hereby surrender all interest to the Gulf Coast Humane Society. My interest in this animal has now been voided and I will not be given any information on the welfare or disposition of this animal.
(Required)
Please type initials above
There is no minimum set time for holding this animal. The holding time depends on the animal’s health, behavior and adoptability. It is also agreed that neither said society nor its management and employees shall incur any obligation to me on the disposition of the above listed animal. I certify that this animal has not bitten another animal or human within the last 10 days. I have read and understand that I have surrendered my rights and interest towards this animal.
Signature
(Required)
Date
(Required)
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
The cost to care for and re-home pets can be in the hundreds of dollars for each animal that comes into our care. GCHS is a private, non-profit organization that does not receive government funding. We are also not affiliated with any national humane organizations. GCHS asks for a surrender fee to help subsidize this cost. The fee is non-refundable and will be collected only if we are able to accept your animal after its evaluation and required testing. Dogs - $100.00 if not spayed/neutered Dogs - $75.00 if spayed/neutered Cats - $50.00
Signature
Date
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Name
This field is for validation purposes and should be left unchanged.
×
Gulf Coast Humane Society
Gulf Coast Humane Society
