Please Copy this form, paste it into an email, fill it out and email with the subject "Owner Surrender" to:
boxeranglesdirectors@yahoo.com
or mail to:
BAR
PO Box 543
N. Bellmore, NY 11710
Name:
Address:
Phone Number:
Best time to call:
Email Address:
Dogs Name:
Age/DOB:
Color:
Gender:
Ears: Cropped or Natural
Tail: Docked or Natural
Approximate weight:
Please answer the following:
1. Are you willing/able to donate an Owner Surrender Fee suggested at $100.00? Other amount?
2. Name, address and telephone number of the Pet Shop, breeder or person you got the dog from:
3. How long have you owned this dog?
4. Why is the dog being given up?
5. What is the name and address of the veterinarian who last treated and vaccinated this dog?
6. Has this dog ever been aggressive or vicious with human beings?
If yes, please describe the circumstances:
7. Has this dog ever bitten anyone?
If yes, please describe the circumstances:
8. 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.
Ref. #1 – Name:
Phone #
Ref. #2 – Name:
Phone #
9. Please provide us with the town name of your local Animal Control Officer and their phone number .
The following
questions will be of help to the person who will adopt your dog. If there is
anything you would like to add that may make your pet's adjustment to a
new home
easier, please feel free to share that information. We want to make the adoption
a success and will work hard to have happy owners with happy dogs.
10.
Please select the adjectives that best describe your dogby selecting each one
that applies and making the word in bold type:
friendly - protective - shy - noisy - quiet - active - playful - nervous - smart - affectionate - aggressive - obedient - calm
11. Is the dog current on vaccinations? Please list dates of vaccinations.
Rabies: DHLPP Bordatella Lyme’s Any others?
12. Date of last heartworm test: Positive or Negative? Is the dog on heartworm preventative?
Brand of heartworm medication dog is taking?
Date of last pill?
13. Is the dog spayed or neutered?
14. Date of last fecal exam for parasites Results If positive, was the dog treated?
15. Medications the dog is taking?
16. Is the dog housetrained?
17. Are there any behavior problems, if so what are they?
18. Does the dog get along with other dogs? Cats? Other animals?
19. Does the dog like children? Are there children in the home? Children’s ages:
20. What BRAND of dog food is the dog fed?
Canned Dry Semi-Moist or a combination
How much is the dog fed? How often is the dog fed?
Are there any specific feeding instructions you wish to share with the new owner?
21. Where does the dog sleep?
22. Is the dog allowed on the furniture? Is the dog crate trained?
23. Where did you keep the dog during the day? At night?
24. How does the dog react to being left alone?
25. Is it afraid of anything in particular? (thunder, men, brooms, etc.)
26. Describe any training the dog has had, or tricks it has learned:
27. Does the dog have any health problems?
28. Does the dog like riding in the car?
29. What is the dogs favorite toys or play thing ? Favorite pastime?
30. What does the dog like?
31. What does the dog dislike?
32. Does the dog jump kiddie gates or fences? If yes, how high does the dog jump:
33. Is the dog a digger?
34. Is there anything else you can share that is special, unusual, or endearing about your dog that would help the new owner?
35. Are there things you think a new owner ought to be aware of?
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.
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
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