Bichon Rescue of Orange County


The primary mission of Bichon Rescue of Orange County (BROC) is to help Bichons and other small breeds that can no longer be cared for by their owners. Although we concentrate our efforts on those in shelters or who have been abandoned or rejected, we realize that there are families who may no longer be able to care for them. We review and evaluate each surrender based on the information provided.

Please read the information on our Re-Homing Process page before completing this form.  We will contact you to arrange a time to evaluate your dog and will advise you of the surrender donation following evaluation.

Thank you,

BROC Leadership Team

Have you read the animal surrender/rehoming information page on our website? *

Your Contact Information

Preferred Contact Method: *

Reason for Surrender

Information About the Dog You Wish to Surrender

Type *
Sex: *
Spayed / Neutered *
Weight: *
Height at the Shoulders *

This Dog's Daily Routine

Is this dog housebroken? *
Does this dog go for walks? *
Does this dog like to ride in the car? *
Is this dog good with children? *
Is this dog good with other dogs? *
Is this dog good with cats? *
Is this dog comfortable around strangers? *
Has this dog ever bitten anyone? *
Is this dog destructive? *
Does this dog demonstrate any anxiety when left alone? *

Health Information For This Dog


Additional Information

By submitting this form, I acknowledge that I am the owner of the dog and I am fully authorized to enter into this Agreement. I proclaim that the information provided on this form is accurate. I understand that Bichon Rescue of Orange County will evaluate my dog before accepting him/her for surrender and rehoming. Once my dog has been accepted, I will hereby permanently and irrevocably transfer ownership of the dog to Bichon Rescue of Orange County. By executing this Agreement, I am irreversibly relinquishing to Bichon Rescue of Orange County all rights, title, and ownership that I had or may have had with respect to the dog.
Adult's Signature Here: *
Bichon Rescue of Orange County Surrender Application 2019