Directions: PLEASE COPY AND PASTE INTO AN EMAIL OR A WORD DOC AND ATTACH TO AN EMAIL, FILL OUT WITH AS MUCH DETAIL AS POSSIBLE. 

Please attach two photos of your dog, one face and one body shot., THEN EMAIL TO rescuecollective@gmail.com. 

E-mail Address: *
Dog Name *

Age *
Birthdate (If known)
Sex * Male
Female
Spayed or Neutered * Yes
No
Current Weight *
Microchip * Yes
No
Microchip Supplier
Microchip Number
Type of Dog *
Size *
Color *
Immunizations and Shots Up to Date? * Yes
No
Next Immunizations Due: *
Bordatella Due: *
Rabies Due: *
Flea and Tick Due: *
Heartworm Due: *
Veterinarian Name: *
Veterinarian Street : *
Veterinarian City: *
Veterinarian State and Zip Code: *
Veterinarian Phone: *
Veterinarian Fax:
Veterinarian e-mail:
List Allergies:
List Other Medical Conditions:
List Medications:
Food Currently Feeding:*
Reason for Rehoming (PLEASE be very honest so we can be honest with potential adopters) *
Can the dog remain in your home until a new home is found? * Yes
No
If no, what is the deadline?
Can you assist in transporting? * Yes
No
Dog Skills and Knowledge
Crate Trained? * Yes
No
Still using Crate? Yes
No
How long in the crate in a 24 hour period?
House Trained? * Yes
No
Walks well on a leash?* Yes
No
Type of Collar used for walking? *
Obedience Training? * Yes
No
If yes, to what level
Can your dog do the following: * Sit
Down
Come
Heel
Leave it
Stay
None of the Above
Has the dog ever run away/escaped? * Yes
No
If yes, how many times?
Does the dog currently have a fenced yard? * Yes
No
If yes, what type of fence?
If you have an e-fence do you have any problems?
Does your dogs get along with.... * Most men
Most women
Most Babies
Most Children under 12
Most Children over 12
Most dogs
Most Cats
Most Other Animals
Dogs your dog typically jump on people? * Yes
No
How does your dog react to strangers? *
Does your dog bark excessively? * Yes
No
Does your dog have separation anxiety? * Yes
No
Dog Hair Shed Factor *
Select Answer Which best Describes your Dogs Coat. *
Describe general temperament of your dog. *
Has your dog Bitten anyone? * Yes
No
If yes, please provide ALL details
Where did you get your dog? *
Is this the dogs first home (beside the original breeder)? * Yes
No
If no, please provide the history of where this dog came from.
Name of Breeder (If applicable)
Has the breeder been notified that you are wanting to rehome? * Yes
No
Does Not Apply
If yes, what was their response?
If no, why have you not contacted them?
Your Information  
Owners Name *
Owner Street: *
Owner City *
Owner State *
Owner Zip Code *
Owner Phone Number *
Owner Alternate Phone
Agreements:
If any information on this form changes you will contact us immediately. * I Agree to contact you.
If you find a home for the dog on your own you will contact us IMMEDIATELY * I Agree!
Please include any additional information or comments, including any other rescue or shelter this dog is listed with:

 

Last updated by LM Fowler - Admin Jun 4, 2011.

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Oodlesofdoodles-rescue@yahoo.com

 

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Oodle ~ Poodle ~ Doodle ~ Fuzzy Critter Rescue / Rehome

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