Surrender Request Form by Cam Thompsen | Mar 23, 2021SURRENDER REQUEST FORM Name Full Name * Your Best Email * Your Phone Number * Street Address * City * State * Zip Code * Dog's Name * Breed * Microchipped? * Yes No Spayed/Neutered? * Yes No Age * Weight * Why Do You Want to Surrender (or Need Assistance with) Your Dog? * Did You Adopt Your Dog, Purchase from a Breeder, or Other? * We Adopted This Dog We Purchased from a Breeder We Acquired Privately What Kind of Food are You Feeding Your Dog? * If Your Dog Has Any Known Allergies, Please List Them: Does Your Dog Have Any Other Medical Issues or Physical Concerns? Please List All Meds and Supplements Your Dog Takes, and the Reason for Each Has Your Dog Ever Been Aggressive Towards (Growling, Lunging, Snapping) or Bitten a Person? If Yes, Explain: * Has Your Dog Ever Been Aggressive Towards (Growling, Lunging, Snapping) or Bitten Another Dog? If Yes, Explain: * Has Your Dog Ever Shown Possessive or Resource Guarding Behaviors Around Food or Toys? Explain: * Has Your Dog Ever Been Cared For by Another Person Outside of Your Home (Pet Sitter, Boarding Facility, Etc.)? * If So, Did Your Dog Have Any Issues During the Time You Were Away? Is Your Dog Housebroken? * Yes No Can Your Dog Remain Calm in a Crate for at Least 4 Hours at a Time? * Yes No What Commands Does Your Dog Know? * What Commands Does Your Dog Listen To the First Time Asked? * Is Your Dog Exercised Outside of Your Home or Yard Daily? * Yes No What Kind of Activities Do You Do Together, and for How Long? * What Kind of Leash, Collar, or Training Tools Do You Use on Walks and at Home? * Does Your Dog Walk Respectfully at Your Side When on Leash? * If Not, What Triggers Any Negative Behaviors? * Can Your Dog Hold a Down & Stay Command (Down/Place/Spot/Bed, etc.) for More Than Ten Minutes? * Yes No Does Your Dog Wait for Permission Before Going Through Thresholds, Getting on Furniture, or Demanding Attention from You? * Yes No What Is Your Dog's Favorite Activity? * What Is Your Dog's LEAST Favorite Activity? * What Would Have to Change in Order for You to Feel that You Have the Ability to Keep Your Dog in Your Home? * SUBMIT REQUEST
