Simulated workplaceCAQA Riverbend Animal Care is a fictional business created by CAQA for training and assessment. It is not a real company and no person, client or record here is real.About this simulation
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CAQA Riverbend Animal Care · Simulated workplace

Animal Surrender Form

FormControlled document
RIV-FRM-002
v3.0
Document ownerShelter Manager
Version3.0
Approved15 January 2026
Next review15 January 2027
StatusCurrent

Purpose. This form records the details, history and legal transfer of ownership when an owner surrenders an animal to the shelter.

1.When to use this form

Use this form whenever an owner or their authorised representative hands an animal to the shelter and gives up ownership. The form must be completed in full and signed before the animal is admitted. Do not use this form for stray animals or for animals seized by animal management officers.

2.Identity and ownership

The worker must sight photo identification and record the name and suburb of the person surrendering. If the person is not the registered owner, they must provide written authority from the owner. Scan the animal for a microchip and compare the registry details with the person present. Discrepancies must be referred to the Shelter Manager before admission.

3.Animal history

Ask about diet, medical history, vaccinations, behaviour with people and other animals, house training and the reason for surrender. This information decides housing, assessment and adoption matching. Record answers as given, without judgement.

  • Reason for surrender
  • Health conditions and medications
  • Behaviour around children, dogs and cats
  • Fears, triggers and favourite activities

4.Transfer of ownership

Read the transfer statement aloud and confirm the person understands that ownership passes to Riverbend on signature, that the animal will be assessed and that Riverbend decides the outcome. The person must sign and date the form and the worker must countersign. Provide a copy on request.

5.After completion

Create the Animal Register record, attach this form and complete the intake steps in the Animal Intake and Admission Procedure. The paper form must be scanned within two working days and filed.

6.Complete the form

RIV-FRM-002 v3.0 · CAQA Riverbend Animal CareUncontrolled when printed. Simulated document created by CAQA for training and assessment.

Used in scenarios

  • Not yet referenced by a scenario.