Dog owner surrender form
Questions marked by * are required.
1. Owners Information - Name *
2. Todays Date
3. Home Number
4. Cell Number
5. Work Number
6. Full Address
7. Email Address *
8. Dogs Information - Name
9. Breed or Breeds?
10. Male or Female?
11. Age?
12. Weight?
13. Spayed and or neutered?
14. Current Shots? Date of last Shots?
15. Name and number of vet who cares for your dog?
16. How long have you owned your dog?
17. Is your dog housetrained?
18. Is your dog Crate trained or run of the house when home alone?
19. If the Dog has (run of the house) How long can he or she be alone before becoming destructive?
20. Is your dog a excessive barker? ( If yes please explain )
21. On heart worm medicine?
22. On flea and tick medicine?
23. Good With Other dogs?
24. Good with cats?
25. Good with kids? What age kids?
26. Is your dog accustomed to a fenced-in-yard? What height and type fence?
27. Is your dog basically a indoor pet? (If not please explain.)
28. Does your dog Walk well on a leash?
29. Is your dog a escape artist? ( If yes please Explain.)
30. Is your dog good with company and strangers?
31. Has your dog shown any kind of aggression? (If yes please explain the circumstances fully.)
32. To your knowledge has your dog Ever BIT a person or another animal?( If yes please explain the circumstances Fully)
33. Is your dog Food Aggressive? (If yes please explain the circumstances.)
34. Still mouthing? (Puppies)
35. Personality and temperament of your dog?
36. The reason for giving up your dog?
37. Profile for your dog? (This is what people will read when viewing the dog on our site.)
38. Any bad habits? ( Please explain)
39. Any health problems? Please explain)
40. Any other significant facts we should know about your dog?
41. I do attest that the dog has never been aggressive to people or another animal (If dog has been aggressive I have written it in the above field and have been honest in my description of the dog(s) behavior). By signing below, I attest that all information given to AFF on this form is true. I understand and agree to follow AFF's terms and conditions in helping me place my dog in a new home. NOTE: Typing your name is accepted as your signature.
42. Date