• Incoming Dog Profile

    The information you provide is CONFIDENTIAL.

  • Thank you for filling out an intake form for Fort Wayne Animal Care & Control. Please understand that you MUST also call and leave a voicemail on the intake help line for a representative to call you back and schedule a time to bring your animal to the shelter. Please sign below confirming you understand that you must call the shelter to schedule a time to bring your animal and this form alone does not mean a time has been set for you. 

  • Part 1: Household

  • If we could help you resolve this issue, would you be interested in keeping this dog?

  • Part 2: Medical History

  • Has this dog seen a veterinarian?
  • Does your dog have any present or past medical conditions?
  • Is your dog currently on any medications or special diets?
  • Is your dog spayed or neutered? (they can't have puppies)
  • What type of food does this dog eat? (Check all that apply)

  • Part 3: Behavior

  • Check all that apply to the personality of this dog:
  • Has this dog been around children?
  • Has this dog lived with children?
  • How does this dog act around children?
  • How does this dog behave around stangers?
  • Has this dog been around other dogs?
  • What size are the dogs this dog has been around?
  • Has this dog lived with other dogs?
  • What size are the dogs this dog has been around?
  • How does this dog behave around other dogs?
  • Would you recommend placing this dog in a home with other dogs?
  • Has this dog been around cats?
  • What age?
  • Has this dog lived with cats?
  • What age?
  • How does this dog behave with cats?
  • Is this dog house trained?
  • Where does this dog stay when alone?
  • In a crate? Wire, plastic or cloth
  • If crated, this dog is (check all that apply)
  • Can this dog be left alone for 8 hours a day without issues?
  • Is this dog destructive when left along?
  • If yes, check all that apply

  • Does this dog escape?
  • How does this dog do on leashed walks?
  • What words does this dog understand (check all that apply):

  • What toys does your dog play with?

  • Please check all that frighten this dog:

  • Does this dog growl, show teeth or "guard" for any of the following?

  • Is guarding behavior towards:
  • Does this dog enjoy being pet/touched.
  • If no, check all areas the dogs does NOT liked being touched

  • Has your dog ever bitten, snapped or nipped?
  • Did the bite break skin?
  • Should be Empty: