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".  

OWNER INFORMATION:

Name:

Address:

City:

State:

Zip:

Home Phone Number:   

Work Phone Number:

Cell Phone Number:

Best number to reach you at and what time of day ? 

Email Address:

Suggested donation fee per each dog surrender is $100.00.  Of course, any additional amount is greatly appreciated.  Are you willing to give our suggested donation?  Yes No

DESCRIPTION OF DOG BEING SURRENDERED:

Dog's Name:

Age & DOB:   

Primary Color: Fawn Brindle White

Gender:   Female Male

Ears:  Natural Cropped

Tail:  Docked Long - Natural

If you will be surrendering another boxer, please check here:

DOG HISTORY: 

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?     Yes No

If Yes, please explain the circumstances. 

Has this dog every bitten anyone?  Yes No

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:       Phone Number:  

Reference #2 - Name:       Phone Number:  

Please provide us with the town name of your local Animal Control Officer and their phone number.

Town ACO:                 Phone Number:  

HEALTH INFORMATION:

What is the name/address/phone number of the veterinarian who last treated and vaccinated this dog? 

Is the dog current on vaccinations?   Yes No

Please list dates of last given vaccinations.

Rabies:                   DHLPP:                 Bordatella:              Lyme: 

Any others?

Please list dates of last tests given:

Heartworm:                 Results:  Negative Positive

Fecal Exam For Parasites:                 Results:  Negative Positive

If Positive, was the dog treated?  Yes No                Is the dog on heartworm preventative?    Yes No

If so, what brand of heartworm medication dog is taking?               Date of last pill? 

Is the dog spayed or neutered?  Yes No

Approximate weight?   Yes No

List any medications the dog is taking? 

If so, what are these medication(s) for? 

GENERAL INFORMATION:

If so what are they? 

Does the dog get along with other dogs?  Yes No

Cats?  Yes No Not Sure

Other animals?  Yes No

Does the dog like children?  Yes No

If you answered "No" to the dog liking children, why?

Are there children in your home?  Yes No

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?  Yes No

How much is the dog fed per feeding? 

How many times is the dog fed per day?  1 2 3

Are there any specific feeding instructions you wish to share with the new owner? 

Where does the dog sleep most of the time? Dog Bed On Family Members Bed Floor Crate Couch Kennel

Is the dog allowed on the furniture?  Yes No

Is the dog crate trained?  Yes No

Where did the dog stay during the day?  Free roam of the house Limited area of the house Crate Kennel

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 Crate Couch Kennel Basement/Garage

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 home/crate

Has your dog suffered from separation anxiety in the last year? Yes No

Is it afraid of anything in particular? (thunder, men, brooms, etc.)  Yes No

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?  Yes No

If yes, please describe: 

Does the dog like riding in the car?  Yes No

What is the dogs favorite toy or play thing?           

Favorite pastime? 

What does the dog like?   

What does the dog dislike?

Does the dog jump baby gates or fences?  Yes No

If yes, please indicate how high the dog jumps: 

Is the dog a digger?  Yes No

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 boxerangelsdirectors@yahoo.com or to our Intake Coordinator Kristi at boxerangelkristine@yahoo.com
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.