Online Owner Surrender Intake Form
BAR only accepts Purebred
Boxers into rescue, no Boxer mixes
Thank you for taking the first step in considering your pet's future
welfare. By placing your dog into our foster program, you will be ensured
that your dog will be provided the best care given by one of our selected,
pre-screened, volunteer foster families. Once your dog has been placed into
a foster home, he/she will be evaluated, provided medical care (if
necessary), and given the utmost love, care and attention it deserves. Of
course, this will be continued into the new home he/she is placed in since
we extensively pre-screen all applicants by phone interviews, reference
checks, home visits, and post adoption updates.
When filling out this form, please be as detailed and honest as possible
to your answers so that it allows us to have the most accurate information
concerning your dog's temperament, personality, and level of obedience it
has currently. This information will be essential to us and your dog in
many ways. It will allow the foster family the opportunity to focus on any
strengths or weakness your pet currently has, routines/commands your pet is
familiar with so adjustment time is much easier, allowing us an idea of any
issues your dog is experiencing thus allowing the new foster home the
opportunity to take the necessary safety measures within their family, and
most important, information that will help the new family adopting your pet
so we can provide a successful and happy placement. Feel free to visit your
pet's new journey, once surrendered, at
www.boxerangelsrescue.com under "Available Boxers".
Home Phone Number:
Work Phone Number:
Cell Phone Number:
Best number to reach you at and what time of day ?
Suggested donation fee per each dog surrender is $100.00. Of course, any
additional amount is greatly appreciated. Are you willing to give our
DESCRIPTION OF DOG BEING SURRENDERED:
Age & DOB:
Long - Natural
If you will be surrendering another boxer, please check here:
Name, address and telephone number of the Pet Shop, breeder or person you
got the dog from:
How long have you owned this dog?
Years and/or Months
Why is the dog being given up?
Has this dog ever been aggressive or vicious with human beings?
If Yes, please explain the
Has this dog every bitten anyone?
If Yes, please explain the circumstances
in detail so that we may better understand the situation.
Please provide us with the name and
phone number of 2 people who know this dog that we may contact as a
reference who are not related to you.
Reference #1 - Name:
Reference #2 - Name:
Please provide us with the town name of
your local Animal Control Officer and their phone number.
What is the name/address/phone number of the veterinarian who last treated
and vaccinated this dog? Please call the vet and give them permission
to share your information with Boxer Angels Rescue.
Is the dog current on vaccinations?
Please list dates of last given vaccinations.
Please list dates of last tests given:
Fecal Exam For Parasites:
If Positive, was the dog
Is the dog on heartworm preventative?
If so, what brand of heartworm medication dog is taking?
Date of last pill?
Is the dog spayed or neutered?
List any medications the dog is taking?
If so, what are these
If so what are they?
Does the dog get along with other dogs?
Does the dog like children?
If you answered "No" to the
dog liking children, why?
Are there children in your home?
What are their ages?
What brand of DRY dog food is the dog fed?
What brand of CANNED dog food is the dog fed?
If you use both dry and
canned, are they mixed together every feeding?
How much is the dog fed per feeding?
How many times is the dog fed per day?
Are there any specific feeding instructions you wish to share with the new
Where does the dog sleep most of the time?
On Family Members Bed
Is the dog allowed on the furniture?
Is the dog crate trained?
Where did the dog stay during the day?
Free roam of the house
Limited area of the house
Where did the dog stay during the night?
Dog Bed In Living Area of Home
On Family Members Bed
Floor In Living Area of Home
How does the dog react to being left alone?
Excellent - Does not chew, destroy, make mess in home/crate, quiet,
settles down quickly
Fair - Can occassionally chew, mess in house/crate, minimal barking
but will settle down eventually
Poor - Will chew, destroy, continious barking, make mess in
Has your dog suffered from separation anxiety in the last year?
Is it afraid of anything in particular? (thunder, men, brooms, etc.)
If you answered "Yes",
please describe what the dog is afraid of:
Describe any training the dog has had, or tricks it has learned:
Does the dog have any health problems?
If yes, please describe:
Does the dog like riding in the car?
What is the dogs favorite toy or play thing?
What does the dog like?
What does the dog dislike?
Does the dog jump baby gates or fences?
If yes, please indicate how high the dog jumps:
Is the dog a digger?
Is there anything else you can share that is special, unusual, or endearing
about your dog that would help the new owner?
Are there any additional things you think a new owner ought to be aware of?
Please send digital pictures of the dog you wish to surrender to
email@example.com or to our Intake Coordinator Kristi at
or you can mail printed pictures to Boxer Angels Rescue, PO Box 543, N.
Bellmore, NY 11710
When surrendering the dog please bring the following items if you have
them: Toys, bowls, crate, blankets, beds, food and any other items you may
have so it will make it easier for the dog to adjust to his/her new home.
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