This form is to be used if you have a dog that you want to relinquish to A Doggie 4 You. The information is required in order to protect us and you should someone try to claim the animal once and if it has come into the rescue. In addition to this form, please submit a photo of the animal if at all possible. Send to adoggie4you2@yahoo.com, be sure to include the your name and the date of this form submission. Submission of this form does not guarantee that A Doggie 4 You will accept the animal.
If you are having a behavior or financial problem with your dog, would you consider keeping him if wecould help you with training, or direct you to a network of individuals that supply food and other petitems to those who need them?
Dog's name if known
Description: color/hairlength/approximate weight *
Estimated age *
Exact birthdate if known
Microchip Number if known
Is this dog spayed/neutered
How long have you had this dog? *
Has your dog ever bitten a person?
a. Was medical attention required?
b. Were animal control, police or paramedics involved?
c. Date of the incident:
Has the dog ever attacked another animal?
If yes,
Please describe what type of animal, date if known and severity of attack
What do I know about this dog?
Choose all that apply:
Good with Large dogs
Good with Small dogs
Good with Cats
Good with Livestock
Ok with Women
Ok with Men
Ok with Children
Food aggressive
Leash trained
Crate trained
Housebroken
I don't know about this animals behaviors
Does the animal have? (Check all that apply)
Choose all that apply:
Fleas
Ticks
Mange
Allergies
Please describe any other known medical or behavioral conditions especially if known to be heartworm positive.
List most recent shots and current medications if known
If this dog was previously adopted from a shelter or rescue provide name and address if known
Why is this dog being surrendered? *
If a stray, what date was the animal found?
Where was the dog found?
What have you done to locate owner? Ex. Posters, notified local shelter, ads
Do you have any additional information that may help us place your dog in the right new home?
If you have been provided this information on a paper form
please sign below
*=required
