Limited Time Only
Free Surrenders for the month of February.

Expires February 28th, 2018.

 First Name  Last Name
 Address  Bld., Flr., Apt #
 City  State  Zip
 Phone Number  Phone Type
Are you over 18?  
Applicant must be over 18.
If you are 17 or younger please have a parent
or guardian fill out the application.
Yes      No
Has your chinchilla(s) been to the vet in the last year?   Yes      No
If yes, why?
Does your chinchilla(s) have any special needs?   Yes      No
If yes, please explain
(i.e. dental problems, skin problems, seizures, phobic of people, bites...)
*Please note, we will NEVER turn away a chinchilla due to a pre-existing condition
Has your chinchilla(s) ever had a cagemate?   Yes      No
If yes, please specify?
Why are you surrendering your chinchilla(s)?  
 Is your chinchilla(s) used to cats/dogs in the home?    Yes      No
If yes, please specify?
Will you be donating your cage?  
Gently used cages only please.
If your cage contains plastic bottom pans please do not donate.
Yes      No
If yes, please list what brand (if known) and the dimensions.
(an estimate of the dimensions is fine)

Owners are responsible for bringing their surrendered chinchillas to a Chin Friends Officer, unless extreme circumstances prevent so. We will do our best to accommodate you, but typically prefer for you to meet us at one of the following locations:

Please select any/all locations you would be able to meet at:

Lindenhurst, NY
Mineola, NY (Train Station)
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