Release to Owner Form
Disaster Preparedness Manual
Melissa J. Nixon, DVM

Animal Name:


Microchip #:    
scanned and confirmed [ ]






ARG Volunteer Name/ID#:

Owner name:

[ ] This animal was presented by owner, the same person is now picking up the animal, and ownership initially confirmed by:

[ ] Microchip OR

[ ] Animal regis. + owner photo ID OR

[ ] Other

If other form of confirmation, describe:

Pre-discharge microchip scan:




Does this match information on admission form? [ ] Yes [ ] No

Does this match information on liability release form? [ ] Yes [ ] No

Does owner have photo ID that matches owner information on forms? [ ] Yes [ ] No

If "no" to one or more, stop NOW and ask for your supervisor!

If yes, proceed with release process. Check off "scanned and confirmed" above.

[ ] This animal was claimed by owner after admission by ARG. The same person who claimed the animal is now wishing to remove the animal from the shelter and ARG's custody.

[ ] Owner has proof of pre-disaster micro chipping in this animal and the information matches our information and today's scan

[ ] Confirm owner ID (photo ID) AND

[ ] Confirm animal ID (microchip scan)

If everything confirms, you may proceed with release process. Check "scanned and confirmed"

[ ] Animal was micro chipped by ARG at or after admission


[ ] This animal has already been claimed and the person wishing to remove the animal today is NOT the same person who has previously claimed ownership of this animal

Stop NOW and ask your supervisor!

[ ] This animal has been claimed by more than one person at the same time and there is dispute

Stop NOW and ask your supervisor!

For use by Supervisor of Animal Releases
Supervisor ARG ID#/name:

Claimant #1 name/contact info:

Claimant #2 name/contact info:


Additional Information Obtained:

Suggested Resolution:

If you have ANY doubts about releasing this animal to this claimant at this time because you are not completely sure that this is the legal owner of this animal, please place a HOLD on the animal. It will continue in our care until we can be sure of the ownership. Please reassure this claimant that nobody else will be able to take the animal until we have resolved the confusion; however, we must hear back from claimant within 72 hours to consider their claim valid. Be sure claimant knows to contact us EVERY DAY until the situation is resolved. Be sure this claimant has all the command center contact information. Start a contact log. Do NOT leave this animal alone with a claimant until the situation is fully resolved. This animal may have supervised visitation only. Please be sure to present this situation at the daily debriefing. [ ] Rresolved and released OR [ ] Animal placed on hold and (other claimant name)        notified

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Melissa J. Nixon, DVM

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