Assisted Rehoming Form

Assisted Rehoming Form

Arctic Breed Rescue Inc.'s focus remains on assisting pound needies within the State of NSW. Should you find yourself in the position of needing to rehome your arctic breed please read this PDF which explains our Assisted Rehoming Program to you. If this is how you wish to progress then please complete the remainder of this form and one of the coordinators will be in touch.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best Contact Number
Please enter a valid phone number.
Email
example@example.com
Briefly explain why you need to rehome your arctic breed.
Animal Name
Animal Breed (Please note we only accept Akita, Alaskan Malamute, Samoyed, Siberian Husky and their crosses)
Animal Birthdate or Approximate Age
Animal Microchip Number
Colour
Gender
Is this animal desexed? Proof will be required.

YesNo
Is this animal up to date with it's vaccinations (minimum C5 level)?

YesNo
If we accept this animal into our program we will ask you to complete a more detailed and thorough profile form. For the time being we appreciate responses to the following questions.
Is your animal dog social? Check all that may apply.

NoAll DogsMales OnlyFemales OnlySelective
If dog social, does this include small dogs?

YesNo
What humans does your dog like? Please check all that apply.

MaleFemaleElderlyNewbornToddlerPrimary School AgeHigh School Age +
Can this dog live with another dog in harmony?

YesNo
What type of playfriend(s) does this dog prefer?
Is this dog a "dog park" dog?

YesNo
Does this dog resource guard any of the following against humans?

FoodToysAttention
Does this dog resource guard any of the following against other dogs?

FoodToysAttention
Does this dog have any medical issues?

YesNo
If you answered yes to any medical issues, please explain.
If this dog is an escape artist how does it escape?

Jumps Fence - 5ft and underJumps Fence - 6ft and underDigsClimbsOnly if you leave the gate / door open
Please check any of the following this dog is friendly with:

CatsBirdsLivestockPoultryNone of the Above
If you have a timeframe in which to rehome this dog, please advise what this is.
Is this dog subject to or under investigation for any of the following orders:

Nuisance DogMenacing DogDangerous Dog
Is there anything else we should know at this stage?
Please upload a picture of this animal.

Cancelof
Should be Empty: