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 Surrender 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

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

Adult's Signature Here: *
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Bichon Rescue of Orange County Surrender Application 2019