Acknowledgements
    Before completing this form to request an appointment with the Intake Coordinator at the Roanoke Valley SPCA, I acknowledge that I have read and understand all of the options listed at www.rvspca.org, and I have to the best of my ability pursued all available alternatives to pet relinquishment.
    I agree*
    Pet Guardian Information
    Please provide the following information about the pet's guardian. This is the person who has legal title to the animal and is requesting the appointment to relinquish custody of the pet. Only the pet's legal guardian may relinquish an animal.
    Pet Information
    Please provide the following information about the pet you wish to surrender to the Roanoke Valley SPCA. If you are requesting an appointment for multiple pets, submit a separate profile for each pet.
    Where did you adopt/purchase your pet?
    Animal Type*:
    Pet's Gender
    Is your pet up to date on vaccinations?
    Has your pet visited a veterinarian for anything beyond routine vaccinations?
    If yes, please list or describe reasons for non-routine visits.
    Does your pet have any medical issues?
    Has your pet ever bitten a person or other animal? If yes, please describe the situation.
    How long have you owned this pet?
    My pet spends the most time*
    Where did you get your pet?
    My pet is litterbox/house trained.*
    Please describe how your pet reacts to visitors.
    Please describe how your pet reacts to other animals.
    Reason(s) you want to give up your pet:
    Please describe any behavior issues that you've observed with your pet.
    Have you taken steps to resolve or remedy the reasons that have led you to give up your pet?*