Dog Surrender Appointment Request

Dog Surrender Appointment Request

Please set aside 15 minutes to complete the form in its entirety.
This application is the first step in the process of having your pet considered for admission. All pets' health and behavior will be evaluated to determine their suitability for placement into foster or adoption home. Please complete one form for each animal being surrendered. Fill out the form in its entirety. If admitted, the detailed and accurate information you provide helps us to determine the best outcome for your pet.
Today's Date *

Month Day Year
Date
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
E-mail *
example@example.com
What is your preferred method of contact? *
Which days of the week and times would you be available for appointments and/or contact? *
For example: Mon-Fri, 8-10
Did you wish to return a pet adopted from the Arizona Humane Society? *

Yes No
Has it been less than 14 days since you adopted this pet? *

Yes No
How many Dogs/Puppies? *

End of Information

Reason for Return - Start
REASON FOR REQUEST
What is your reason for requesting to surrender this pet? (Please check all that apply) *

Behavior issue (aggression, separation anxiety, destructive behavior, etc.) Too many animals/unwanted litter Pets do not get along Doesn't fit my lifestyle/don't have time Allergic to pet Moving (can't take pet) Divorce, separation, or loss of head of household Owner deceased/pet abandoned by owner Military deployment Lost job Eviction/lost home (need temporary housing/boarding) Can't afford to care for pet (pet food, supplies, veterinary care) Can't find affordable pet-friendly housing/pay pet deposit Emergency or planned hospitalization/short term injury or illness Fleeing domestic violence Other Reason
RESOURCES
Many pet owners face challenging situations and feel that turning their pet into a shelter is their only option. Depending on your situation, there may be resources available to you that would allow you to keep your pet! Please view our Pet Owner Resources webpage or our list of Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.
No Time for Pet

Experts in the animal field agree that a dog requires a mere 15 minutes of one-on-one time with his human per day to be happy, healthy, and well-adjusted! That could be simply spent laying in bed at night watching t.v. together, playing ball in the backyard for 15 minutes while dinner is cooking, or going for a walk or jog!

Cats and dogs can also benefit from environmental enrichment. Setting aside a few minutes each day to make their lives more interesting could make a big difference to their behavior.

And don't forget pets reduce personal stress and can add years to your life.
Training/Behavior Help

Often behavior issues can be addressed with minor changes to your routine or household. We can assist you with troubleshooting minor behavioral issues or referring you to appropriate resources for more severe problems.

Please view our Pet Training Resources.

Some behavioral issues can be a symptom of underlying medical issues and can be easily fixed by receiving veterinary care.

Please click this link to view a list of affordable veterinary services and assistance.
Furry Family Fix Program and Spay/Neuter Assistance

In our continued efforts to combat pet overpopulation through increasing spay/neuter resources, AHS is introducing the Furry Family Fix program, aimed at helping families that have had litters of puppies and kittens. Under the Furry Family Fix program, AHS will waive the surrender fee for litters of puppies and kittens, while offering the pet owner a free spay/neuter voucher, through our Circle of Friends, for the litter’s mom and/or dad that can be used at one of our public clinics.

Individuals wishing to participate in the Furry Family Fix program must be the owner of the puppies/kittens as well as the litter’s mom and/or dad. Puppies/kittens must be at least 8 weeks of age but cannot exceed 6 months of age to qualify for the program, and should be in good health.

To schedule a spay/neuter appointment for our Furry Family Fix program, call AHS Pet Resource Center at 602.997.7585 ext. 3800.

Thanks to our generous grants, we are able to offer Spay/Neuter assistance for customers in financial need. Please call either clinic listed below closest to your home, and ask a team member about various options for your pet. Low-cost spay/neuter vouchers are made possible by generous grants from PetSmart Charities, Circle of Friends, and Fix. Adopt. Save.

Book a spay/neuter appointment at our Marge Wright Veterinary Clinic by scheduling online or calling 602.997.7585 Ext. 4001.
Managing Pet Allergies

If someone in your home has been diagnosed with allergies by an allergist, carefully consider if you can live with or manage the symptoms. Children may outgrow pet allergies while others are able to manage their symptoms and keep their pet in their home. To learn more, visit our Managing Pet Allergies webpage.
Rehoming

There are many people in the Valley looking for a new pet just like yours. Before considering surrendering your pet to a shelter, see if you can find another family who may be interested in giving your pet a new home. Visit our Re-Home Your Pet webpage for tips on how to re-home.
Finding Pet-Friendly Housing

We get it - life happens! And we know you want the best for your animal. If your life change is anticipated, we recommend doing everything possible to rehome your animal on your own. If you have recently lost your home or need to move, we can sometimes assist with navigating rental policies on having animals or finding pet-friendly housing. Please download tips on how to Conduct a Successful Housing Search and how to Rent Successfully with Pets.
Finding Pet-Friendly Housing

We know you want the best for your animal. If you need to move due to a domestic violence situation or house instability, we can assist with navigating rental policies on having animals or finding pet-friendly housing. Please download tips on how to Conduct a Successful Housing Search and how to Rent Successfully with Pets.
Low-Cost Veterinary Care, Vaccines, Spay and Neuter, Pet Food and Supplies

We offer a variety of resources that may help you care for your pet during this time of crisis.

Veterinary Services and Assistance

Pet Food Assistance
Resources for Pet Owners in Crisis

If you currently experiencing a crisis (i.e. eviction or loss of housing, emergency or long-term medical or behavioral health hospitalization, short-term injury or illness, or seeking safety from domestic violence), you can find information about eviction, rental, mortgage, and utility assistance programs as well as domestic violence support services. View Resources for Pet Families Experiencing Financial Hardship.
Bridge the Gap

AHS, in partnership with the Nina Mason Pulliam Charitable Trust, has launched the Bridge the Gap program within our Pet Resource Center to support pet owners in crisis. As part of the Bridge the Gap program, the Arizona Humane Society has the Real-Time Solutions Fund. This fund is a one-time grant to assist pet owners in need who are financially struggling to keep their pets due to unforeseen hardship. If you need assistance with paying for a Pet Deposit, buying supplies that will help you keep your pet safe with you (i.e. crates, outdoor kennels, other pet supplies) or your pet is in need of medical care that you are unable to afford at this time, you can apply for assistance.

Click this link to complete the Bridge the Gap Pet Family Resource Referral form.
Would 90 days or less of Temporary Care prevent your need to surrender? *

Yes No
Temporary Foster Care for Pet Owners in Crisis

Our Project Home Away From Home program provides temporary foster care (typically 30-90 days) for the pets of families in a critical time of need. This could include situations such as medical or behavioral health hospitalization, domestic violence survivors seeking safety for themselves and their pets, or for those experiencing a loss of stable housing due to unforeseen circumstances. Your pet must pass the behavior and medical exam to be accepted. If you are experiencing a crisis and need temporary foster for your pet, click azhumane.org/tempcare to apply for Project Home Away From Home.

Reason for Return - End

Book Appointment - Start
Book an Adoptions Return Appointment
We also understand that sometimes circumstances change, and our 100 percent adoption guarantee ensures that you can return your pet to us at any time within the pet’s lifetime for any reason with an adoption return appointment. Appointment availability varies. Click here to schedule an appointment to return a pet you adopted from AHS.

Book Appointment - End

Dog 1- Start of Section
DOG ONE INFORMATION
Dog's Name? *
Animal ID# (if known):
This can be found on the Adoption Agreement.
Gender? *
Approximate Age? (Years/Months/Weeks) *
Primary Color? *
Primary Breed? *
Size? *
History
Has this dog ever bitten a person? *

Yes No
Did the last bite occur within the last ten days? *

Yes No
What were the extent of the injuries? *

Snapped, but didn't make contact Made contact but did not break the skin Made contact, some redness or light bruising but did not break the skin Broke skin (a skin nick or puncture with slight bleeding) One to four punctures from a single bite with bruising Multiple bites, punctures, or cuts
Has the dog ever been in a fight with another dog? *

Yes No Unsure
How many times has this dog fought with another dog? *
Describe the circumstances of the incident(s). Where was the fight (home, on walk, dog park etc.) What exactly happened? Have you sought out professional training? *
What were the extent of the injuries? *

No major injuries Minor scrapes or shallow punctures Deep punctures in multiple areas Injuries required stitches Injuries required emergency medical treatment/surgery Other dog did not survive
How many times did this occur, every fight or just once? *
Has this dog been diagnosed or treated for any of the following medical condition(s)? (Check all that apply) *

Allergies (Severe) Arthritis (Severe) Autoimmune Disease Bladder Stones Cancer Cushings or Addison's Disease Distemper Diabetes Disc (Back) Problems Seizures Heart Disease Heartworm Hip Dysplasia Kidney Disease or Failure Ringworm Valley Fever None of the Above
Does this dog have any urgent medical needs? *

Yes No
Please describe: *
Is this dog on Fluoxetine, Prozac, Trazodone, or Gabapentin? *

Yes No

Dog 1- End of Section

Dog 1 - Start Options
Your Options - Dog One

Unfortunately, not all animals are suitable for adoption as many medical or behavioral conditions are not treatable in the shelter environment. We cannot accept animals that are aggressive, have a bite history, or have severe medical conditions.

Based on your responses, we may be able to offer your pet a better outcome by providing you resources that may allow you to keep your pet. Please view our Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.

If you can no longer care for your pet, you can explore tips on rehoming your pet on our website or visit AZ Pet Housing Help to find resources to help find a temporary foster home or a permanent home for your pet.

If you cannot find an alternative, you may have to make the difficult determination to euthanize the pet humanely. Please visit our end-of-life services webpage to schedule an appointment.
This dog has passed the first step. The next step in the process is to complete a Pet Profile. Once we receive the form, we may follow up with you within 48 hours to ask additional questions and discuss services available to you and your pet. Please click continue to display the Pet Profile for this pet at the bottom of the form. *

Continue

Dog 1 - End Options

Dog 2 - Start of Section
DOG TWO INFORMATION
Dog's Name? *
Gender? *
Approximate Age? (Years/Months/Weeks) *
Primary Color? *
Primary Breed? *
Size? *
History
Has this dog ever bitten a person? *

Yes No
Did the last bite occur within the last ten days? *

Yes No
What were the extent of the injuries? *

Snapped, but didn't make contact Made contact but did not break the skin Broke skin (a skin nick or puncture with slight bleeding) One to four punctures from a single bite with bruising Multiple bites, punctures, or cuts
Has the dog ever been in a fight with another dog? *

Yes No Unsure
How many times has this dog fought with another dog? *
Describe the circumstances of the incident. Where was the fight (home, on walk, dog park etc.) What exactly happened? Have you sought out professional training? *
What were the extent of the injuries? *

No major injuries Minor scrapes or shallow punctures Deep punctures in multiple areas Injuries required stitches Injuries required emergency medical treatment/surgery Other dog did not survive
How many times did this occur, every fight or just once? *
Has this dog been diagnosed or treated for any of the following medical condition(s)? (Check all that apply) *

Allergies (Severe) Arthritis (Severe) Autoimmune Disease Bladder Stones Cancer Cushings or Addison's Disease Distemper Diabetes Disc (Back) Problems Seizures Heart Disease Heartworm Hip Dysplasia Kidney Disease or Failure Ringworm Valley Fever None of the Above
Does this dog have any urgent medical needs? *

Yes No
Please describe: *
Is this dog on Fluoxetine, Prozac, Trazodone, or Gabapentin? *

Yes No

Dog 2 - End of Section

Dog 2 - Start Options
Your Options - Dog Two

Unfortunately, not all animals are suitable for adoption as many medical or behavioral conditions are not treatable in the shelter environment. We cannot accept animals that are aggressive, have a bite history, or have severe medical conditions.

Based on your responses, we may be able to offer your pet a better outcome by providing you resources that may allow you to keep your pet. Please view our Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.

If you can no longer care for your pet, you can explore tips on rehoming your pet on our website or visit AZ Pet Housing Help to find resources to help find a temporary foster home or a permanent home for your pet.

If you cannot find an alternative, you may have to make the difficult determination to euthanize the pet humanely. Please visit our end-of-life services webpage to schedule an appointment.
This dog has passed the first step. The next step in the process is to complete a Pet Profile. Once we receive the form, we may follow up with you within 48 hours to ask additional questions and discuss services available to you and your pet. Please click continue to display the Pet Profile for this pet at the bottom of the form. *

Continue

Dog 2 - End Options

Dog 3 - Start of Section
DOG THREE INFORMATION
Dog's Name? *
Gender? *
Approximate Age? (Years/Months/Weeks) *
Primary Color? *
Primary Breed? *
Size? *
History
Has this dog ever bitten a person? *

Yes No
Did the last bite occur within the last ten days? *

Yes No
What were the extent of the injuries? *

Snapped, but didn't make contact Made contact but did not break the skin Broke skin (a skin nick or puncture with slight bleeding) One to four punctures from a single bite with bruising Multiple bites, punctures, or cuts
Has the dog ever been in a fight with another dog? *

Yes No Unsure
How many times has this dog fought with another dog? *
Describe the circumstances of the incident. Where was the fight (home, on walk, dog park etc.) What exactly happened? Have you sought out professional training? *
What were the extent of the injuries? *

No major injuries Minor scrapes or shallow punctures Deep punctures in multiple areas Injuries required stitches Injuries required emergency medical treatment/surgery Other dog did not survive
How many times did this occur, every fight or just once? *
Has this dog been diagnosed or treated for any of the following medical condition(s)? (Check all that apply) *

Allergies (Severe) Arthritis (Severe) Cancer Cushings or Addison's Disease Distemper Diabetes Disc (Back) Problems Epilepsy Heart Disease Heartworm Hip Dysplasia Kidney Disease or Failure Ringworm Valley Fever None of the Above
Does this dog have any urgent medical needs? *

Yes No
Please describe: *
Is this dog on Fluoxetine, Prozac, Trazodone, or Gabapentin? *

Yes No

Dog 3 - End of Section

Dog 3 - Start Options
Your Options - Dog Three

Unfortunately, not all animals are suitable for adoption as many medical or behavioral conditions are not treatable in the shelter environment. We cannot accept animals that are aggressive, have a bite history, or have severe medical conditions.

Based on your responses, we may be able to offer your pet a better outcome by providing you resources that may allow you to keep your pet. Please view our Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.

If you can no longer care for your pet, you can explore tips on rehoming your pet on our website or visit AZ Pet Housing Help to find resources to help find a temporary foster home or a permanent home for your pet.

If you cannot find an alternative, you may have to make the difficult determination to euthanize the pet humanely. Please visit our end-of-life services webpage to schedule an appointment.
This dog has passed the first step. The next step in the process is to complete a Pet Profile. Once we receive the form, we may follow up with you within 48 hours to ask additional questions and discuss services available to you and your pet. Please click continue to display the Pet Profile for this pet at the bottom of the form. *

Continue

Dog #3 - End Options One

Dog #4 - Start of Section
DOG FOUR INFORMATION
Dog's Name? *
Gender? *
Approximate Age? (Years/Months/Weeks) *
Primary Color? *
Primary Breed? *
Size? *
History
Has this dog ever bitten a person? *

Yes No
Did the last bite occur within the last ten days? *

Yes No
What were the extent of the injuries? *

Snapped, but didn't make contact Made contact but did not break the skin Broke skin (a skin nick or puncture with slight bleeding) One to four punctures from a single bite with bruising Multiple bites, punctures, or cuts
Has the dog ever been in a fight with another dog? *

Yes No Unsure
How many times has this dog fought with another dog? *
Describe the circumstances of the incident. Where was the fight (home, on walk, dog park etc.) What exactly happened? Have you sought out professional training? *
What were the extent of the injuries? *

No major injuries Minor scrapes or shallow punctures Deep punctures in multiple areas Injuries required stitches Injuries required emergency medical treatment/surgery Other dog did not survive
How many times did this occur, every fight or just once? *
Has this dog been diagnosed or treated for any of the following medical condition(s)? (Check all that apply) *

Allergies (Severe) Arthritis (Severe) Autoimmune Disease Bladder Stones Cancer Cushings or Addison's Disease Distemper Diabetes Disc (Back) Problems Seizures Heart Disease Hearworm Hip Dysplasia Kidney Disease or Failure Ringworm Valley Fever None of the Above
Does this dog have any urgent medical needs? *

Yes No
Please describe: *
Is this dog on Fluoxetine, Prozac, Trazodone, or Gabapentin? *

Yes No

Dog 4 - End of Section

Dog 4 - Start Options
Your Options - Dog Four

Unfortunately, not all animals are suitable for adoption as many medical or behavioral conditions are not treatable in the shelter environment. We cannot accept animals that are aggressive, have a bite history, or have severe medical conditions.

Based on your responses, we may be able to offer your pet a better outcome by providing you resources that may allow you to keep your pet. Please view our Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.

If you can no longer care for your pet, you can explore tips on rehoming your pet on our website or visit AZ Pet Housing Help to find resources to help find a temporary foster home or a permanent home for your pet.

If you cannot find an alternative, you may have to make the difficult determination to euthanize the pet humanely. Please visit our end-of-life services webpage to schedule an appointment.
This dog has passed the first step. The next step in the process is to complete a Pet Profile. Once we receive the form, we may follow up with you within 48 hours to ask additional questions and discuss services available to you and your pet. Please click continue to display the Pet Profile for this pet at the bottom of the form. *

Continue

Dog 4 - End Options

Dog 5 - Start of Section
DOG FIVE INFORMATION
Dog's Name? *
Animal ID# (if known):
This can be found on the Adoption Agreement.
Gender? *
Approximate Age? (Years/Months/Weeks) *
Primary Color? *
Primary Breed? *
Size? *
History
Has this dog ever bitten a person? *

Yes No
Did the last bite occur within the last ten days? *

Yes No
What were the extent of the injuries? *

Snapped, but didn't make contact Made contact but did not break the skin Broke skin (a skin nick or puncture with slight bleeding) One to four punctures from a single bite with bruising Multiple bites, punctures, or cuts
Has the dog ever been in a fight with another dog? *

Yes No Unsure
How many times has this dog fought with another dog? *
Describe the circumstances of the incident. Where was the fight (home, on walk, dog park etc.) What exactly happened? Have you sought out professional training? *
What were the extent of the injuries? *

No major injuries Minor scrapes or shallow punctures Deep punctures in multiple areas Injuries required stitches Injuries required emergency medical treatment/surgery Other dog did not survive
How many times did this occur, every fight or just once? *
Has this dog been diagnosed or treated for any of the following medical condition(s)? (Check all that apply) *

Allergies (Severe) Arthritis (Severe) Autoimmune Bladder Stones Cancer Cushings or Addison's Disease Distemper Diabetes Disc (Back) Problems Seizures Heart Disease Heartworm Hip Dysplasia Kidney Disease or Failure Ringworm Valley Fever None of the Above
Does this dog have any urgent medical needs? *

Yes No
Please describe: *
Is this dog on Fluoxetine, Prozac, Trazodone, or Gabapentin? *

Yes No

Dog 5 - End of Section

Dog 5 - Start Options
Your Options - Dog Five

Unfortunately, not all animals are suitable for adoption as many medical or behavioral conditions are not treatable in the shelter environment. We cannot accept animals that are aggressive, have a bite history, or have severe medical conditions.

Based on your responses, we may be able to offer your pet a better outcome by providing you resources that may allow you to keep your pet. Please view our Pet Resources to find tips on how to rehome your pet and find assistance getting affordable medical and pet care, behavior advice and training, support services for owners in need, temporary foster care for your pet, and help to find pet-friendly housing.

If you can no longer care for your pet, you can explore tips on rehoming your pet on our website or visit AZ Pet Housing Help to find resources to help find a temporary foster home or a permanent home for your pet.

If you cannot find an alternative, you may have to make the difficult determination to euthanize the pet humanely. Please visit our end-of-life services webpage to schedule an appointment.
This dog has passed the first step. The next step in the process is to complete a Pet Profile. Once we receive the form, we may follow up with you within 48 hours to ask additional questions and discuss services available to you and your pet. Please click continue to display the Pet Profile for this pet at the bottom of the form. *

Continue

Dog 5 - End Options

Pet Profile Explanation - START
Pet Profile
Before scheduling your appointment:
- As our goal is to find a fur-ever home for every healthy and treatable animal, we need to know as much as we can about the animals that come into our care. We require to complete this Pet Profile in its entirety.
- Once you submit the form, click the link in the confirmation text to schedule the appointment.
- An Admissions Specialist may contact you after reviewing if they need more information on the pet's medical history, habits, behaviors, and temperament.
During your appointment:
- Only the legal owner of an animal may surrender. We CANNOT accept pets from family members or friends. Be sure that dogs are on leashes and cats or other small animals are in carriers.
- Your appointment will take approximately 30-45 minutes per pet and will include a health exam and behavior evaluation to determine if the pet is a candidate for our adoption program. Once complete, we will explain your pet's likely outcome should they be surrendered so you can make the best decision for you and your pet. If your animal is suffering medically or behaviorally and treatment is not a viable option, we can provide end-of-life care.
- The cost to surrender is $75 per animal. This fee will be put toward the cost of your pet's care during their stay with us. Please bring a copy of your pet's veterinary records and any unopened food, litter, grooming supplies, toys, or bedding you may wish to donate.
Next steps:
- If you need to reschedule or cancel your appointment, please do so at least 24 hours before so we can save another animal’s life. Click on the “Change/Cancel Appointment” link located at the bottom of your appointment confirmation email.
- While we do everything we can to rescue, heal and adopt our pets, we cannot guarantee that your animal will be placed for adoption due to unforeseen medical conditions, behavioral reactions in a shelter environment. If the decision is made to humanely euthanize the pet due to their extensive medical or behavioral needs, you can request to be notified and reclaim your pet. You will assume responsibility (including all financial costs) for any medical care your pet requires based on medical evaluation.

Pet Profile Explanation End

Pet Profile - START Dog/Puppy #1
DOG ONE PROFILE
Dog's Name: *
Behavior
Describe this dog's behavior towards family members. *
Describe this dog's behavior with unfamiliar people (visiting adults and children, service technicians, delivery workers) who come to the home. *
Has this dog met any unfamiliar dogs? If so, please describe their behavior when meeting them.
Has this dog ever been walked on a leash? *

Yes No

How does this dog behave while on walks when approaching: (Check all that apply) *

	Little/No Reaction	Friendly	Barks	Growls/ Shows Teeth	Pulls on Leash	Hard to Control/ Has Gotten Away
Unfamiliar Person
Unfamiliar Dog
Cat or Critter
Bicyclists, Joggers, Skateboards

How does this dog behave when you or another family member does the following: (Check all that apply) *

	Little/No Reaction	Enjoys	Afraid/ Avoids	Growls/ Shows Teeth	Snaps/ Bites	No History
Bathe
Brush
Wipe Paws
Trim Nails

Is this dog afraid of anything? If so, what are they afraid of?
Has this dog escaped your property in the last six months? If so, please describe the incident and how the dog escaped:
Has this dog been seen by a veterinarian or groomer? *

Yes No Not Sure
When was this dog last seen by veterinarian? *
Month, Year
Please provide the veterinarian's or clinic's name and phone number:
Please describe how this dog behaves at the veterinarian or groomer. *
Does this dog have to be muzzled at the veterinarian or groomer? *

Yes No Not Sure
Homelife
This dog has lived with: (Check all that apply) *

Men Women Senior Citizens Teenagers Children Toddlers Babies
Has this dog lived with: (Check all that apply) *

Small Dogs Large Dogs Cats Critters This dog has not lived with any other animals
Please describe the breed and age of these animals and how this dog behaves with them: *
Is this dog potty-trained/housebroken? *
Where does this dog spend most of their time when someone is home? *
Please describe where this dog spends their time when someone is home:
Where does this dog stay when no one is home? *
Please describe where this dog stays when alone:
How long is this dog left alone? *
When left alone, does this dog usually show any of the following behaviors? (Check all that apply) *

Urinates and/or defecates where they shouldn't Barks, cries, howls for long periods Barks, whines then stops Destroys things Other
Please describe what this dog destroys:
Please describe what behaviors this dog shows:
Is the dog allowed on furniture? *

Yes No
Where does this dog usually sleep overnight? *
What is this dog's behavior when riding in a car?
What commands does this dog know? (Check all that apply) *

Sit Down Stay Shake/High Five Come Heel None Other
Please list what other commands this dog knows:
Does this dog know any special tricks?

Yes No
Please describe:
This dog's energy level is best described as: *

Lazy. couch potato Medium, likes to play, but also relax Energetic, could play all day
When this dog plays, do they typically do any of the following? (Check all that apply) *

Jumps Growls Barks Bites gently Bites hard This dog doesn't play Other
Please describe what they do when they play:
What toys does this dog like? (Check all that apply) *

Balls Frisbee Stuffed Squeaky Tug/Rope This dog doesn't play with toys Other
Please list what other toys this dog likes:
What games does this dog like? (Check all that apply) *

Fetch Tug Chase Wrestling Hide and Seek This dog doesn't play games Other
Please list what other games this dog likes:
Has this dog attended any obedience or training classes? *

Yes No
Please describe the kind of classes and where this dog attended them.
What type of food/treats does this dog eat? *
Do you feed this dog people food? *

Yes No
Please tell us about this dog's "bad habits" or fears (chewing shoes, jumping on counters or people, hiding during thunderstorms, etc.):
Please tell us anything about your dog that might help us find their perfect future furever/foster home (loves to hike, great with kids, has lived with other pets, etc.):

Dog/Puppy Section 1 - END

Dog/Puppy Section 2 - START
DOG TWO PROFILE
Dog's Name:
Behavior
Describe this dog's behavior towards family members. *
Describe this dog's behavior with unfamiliar people (visiting adults and children, service technicians, delivery workers) who come to the home. *
Has this dog met any unfamiliar dogs? If so, please describe their behavior when meeting them.
Has this dog ever been walked on a leash? *

Yes No

How does this dog behave while on walks when approaching: (Check all that apply) *

	Little/No Reaction	Friendly	Barks	Growls/ Shows Teeth	Pulls on Leash	Hard to Control/ Has Gotten Away
Unfamiliar Person
Unfamiliar Dog
Cat or Critter
Bicyclists, Joggers, Skateboards

How does this dog behave when you or another family member does the following: (Check all that apply) *

	Little/No Reaction	Enjoys	Afraid/ Avoids	Growls/ Shows Teeth	Snaps/ Bites	No History
Bathe
Brush
Wipe Paws
Trim Nails

Is this dog afraid of anything? If so, what are they afraid of?
Has this dog escaped your property in the last six months? If so, please describe the incident and how the dog escaped:
Has this dog been seen by a veterinarian or groomer? *

Yes No Not Sure
When was this dog last seen by veterinarian? *
Month, Year
Please provide the veterinarian's or clinic's name and phone number:
Please describe how this dog behaves at the veterinarian or groomer. *
Does this dog have to be muzzled at the veterinarian or groomer? *

Yes No Not Sure
Homelife
This dog has lived with: (Check all that apply) *

Men Women Senior Citizens Teenagers Children Toddlers Babies
Has this dog lived with: (Check all that apply) *

Small Dogs Large Dogs Cats Critters This dog has not lived with any other animals
Please describe the breed and age of these animals and how this dog behaves with them: *
Is this dog potty-trained/housebroken? *
Where does this dog spend most of their time when someone is home? *
Please describe where this dog spends their time when someone is home:
Where does this dog stay when no one is home? *
Please describe where this dog stays when alone:
How long is this dog left alone? *
When left alone, does this dog usually show any of the following behaviors? (Check all that apply) *

Urinates and/or defecates where they shouldn't Barks, cries, howls for long periods Barks, whines then stops Destroys things Other
Please describe what this dog destroys:
Please describe what behaviors this dog shows:
Is the dog allowed on furniture? *

Yes No
Where does this dog usually sleep overnight? *
What is this dog's behavior when riding in a car?
What commands does this dog know? (Check all that apply) *

Sit Down Stay Shake/High Five Come Heel None Other
Please list what other commands this dog knows:
Does this dog know any special tricks?

Yes No
Please describe:
This dog's energy level is best described as: *

Lazy. couch potato Medium, likes to play, but also relax Energetic, could play all day
When this dog plays, do they typically do any of the following? (Check all that apply) *

Jumps Growls Barks Bites gently Bites hard This dog doesn't play Other
Please describe what they do when they play:
What toys does this dog like? (Check all that apply) *

Balls Frisbee Stuffed Squeaky Tug/Rope This dog doesn't play with toys Other
Please list what other toys this dog likes:
What games does this dog like? (Check all that apply) *

Fetch Tug Chase Wrestling Hide and Seek This dog doesn't play games Other
Please list what other games this dog likes:
Has this dog attended any obedience or training classes? *

Yes No
Please describe the kind of classes and where this dog attended them.
What type of food/treats does this dog eat? *
Do you feed this dog people food? *

Yes No
Please tell us about this dog's "bad habits" or fears (chewing shoes, jumping on counters or people, hiding during thunderstorms, etc.):
Please tell us anything about your dog that might help us find their perfect future furever/foster home (loves to hike, great with kids, has lived with other pets, etc.):

Dog/Puppy Section 2 - End

Dog/Puppy Section 3 - START
DOG THREE PROFILE
Dog's Name:
Behavior
Describe this dog's behavior towards family members. *
Describe this dog's behavior with unfamiliar people (visiting adults and children, service technicians, delivery workers) who come to the home. *
Has this dog met any unfamiliar dogs? If so, please describe their behavior when meeting them.
Has this dog ever been walked on a leash? *

Yes No

How does this dog behave while on walks when approaching: (Check all that apply) *

	Little/No Reaction	Friendly	Barks	Growls/ Shows Teeth	Pulls on Leash	Hard to Control/ Has Gotten Away
Unfamiliar Person
Unfamiliar Dog
Cat or Critter
Bicyclists, Joggers, Skateboards

How does this dog behave when you or another family member does the following: (Check all that apply) *

	Little/No Reaction	Enjoys	Afraid/ Avoids	Growls/ Shows Teeth	Snaps/ Bites	No History
Bathe
Brush
Wipe Paws
Trim Nails

Is this dog afraid of anything? If so, what are they afraid of?
Has this dog escaped your property in the last six months? If so, please describe the incident and how the dog escaped:
Has this dog been seen by a veterinarian or groomer? *

Yes No Not Sure
When was this dog last seen by veterinarian? *
Month, Year
Please provide the veterinarian's or clinic's name and phone number:
Please describe how this dog behaves at the veterinarian or groomer. *
Does this dog have to be muzzled at the veterinarian or groomer? *

Yes No Not Sure
Homelife
This dog has lived with: (Check all that apply) *

Men Women Senior Citizens Teenagers Children Toddlers Babies
Has this dog lived with: (Check all that apply) *

Small Dogs Large Dogs Cats Critters This dog has not lived with any other animals
Please describe the breed and age of these animals and how this dog behaves with them: *
Is this dog potty-trained/housebroken? *
Where does this dog spend most of their time when someone is home? *
Please describe where this dog spends their time when someone is home:
Where does this dog stay when no one is home? *
Please describe where this dog stays when alone:
How long is this dog left alone? *
When left alone, does this dog usually show any of the following behaviors? (Check all that apply) *

Urinates and/or defecates where they shouldn't Barks, cries, howls for long periods Barks, whines then stops Destroys things Other
Please describe what this dog destroys:
Please describe what behaviors this dog shows:
Is the dog allowed on furniture? *

Yes No
Where does this dog usually sleep overnight? *
What is this dog's behavior when riding in a car?
What commands does this dog know? (Check all that apply) *

Sit Down Stay Shake/High Five Come Heel None Other
Please list what other commands this dog knows:
Does this dog know any special tricks?

Yes No
Please describe:
This dog's energy level is best described as: *

Lazy. couch potato Medium, likes to play, but also relax Energetic, could play all day
When this dog plays, do they typically do any of the following? (Check all that apply) *

Jumps Growls Barks Bites gently Bites hard This dog doesn't play Other
Please describe what they do when they play:
What toys does this dog like? (Check all that apply) *

Balls Frisbee Stuffed Squeaky Tug/Rope This dog doesn't play with toys Other
Please list what other toys this dog likes:
What games does this dog like? (Check all that apply) *

Fetch Tug Chase Wrestling Hide and Seek This dog doesn't play games Other
Please list what other games this dog likes:
Has this dog attended any obedience or training classes? *

Yes No
Please describe the kind of classes and where this dog attended them.
What type of food/treats does this dog eat? *
Do you feed this dog people food? *

Yes No
Please tell us about this dog's "bad habits" or fears (chewing shoes, jumping on counters or people, hiding during thunderstorms, etc.):
Please tell us anything about your dog that might help us find their perfect future furever/foster home (loves to hike, great with kids, has lived with other pets, etc.):

Dog/Puppy Section 3 - END

Dog/Puppy Section 4 - START
DOG FOUR PROFILE
Dog's Name:
Behavior
Describe this dog's behavior towards family members. *
Describe this dog's behavior with unfamiliar people (visiting adults and children, service technicians, delivery workers) who come to the home. *
Has this dog met any unfamiliar dogs? If so, please describe their behavior when meeting them.
Has this dog ever been walked on a leash? *

Yes No

How does this dog behave while on walks when approaching: (Check all that apply) *

	Little/No Reaction	Friendly	Barks	Growls/ Shows Teeth	Pulls on Leash	Hard to Control/ Has Gotten Away
Unfamiliar Person
Unfamiliar Dog
Cat or Critter
Bicyclists, Joggers, Skateboards

How does this dog behave when you or another family member does the following: (Check all that apply) *

	Little/No Reaction	Enjoys	Afraid/ Avoids	Growls/ Shows Teeth	Snaps/ Bites	No History
Bathe
Brush
Wipe Paws
Trim Nails

Is this dog afraid of anything? If so, what are they afraid of?
Has this dog escaped your property in the last six months? If so, please describe the incident and how the dog escaped:
Has this dog been seen by a veterinarian or groomer? *

Yes No Not Sure
When was this dog last seen by veterinarian? *
Month, Year
Please provide the veterinarian's or clinic's name and phone number:
Please describe how this dog behaves at the veterinarian or groomer. *
Does this dog have to be muzzled at the veterinarian or groomer? *

Yes No Not Sure
Homelife
This dog has lived with: (Check all that apply) *

Men Women Senior Citizens Teenagers Children Toddlers Babies
Has this dog lived with: (Check all that apply) *

Small Dogs Large Dogs Cats Critters This dog has not lived with any other animals
Please describe the breed and age of these animals and how this dog behaves with them: *
Is this dog potty-trained/housebroken?
Where does this dog spend most of their time when someone is home? *
Please describe where this dog spends their time when someone is home:
Where does this dog stay when no one is home? *
Please describe where this dog stays when alone:
How long is this dog left alone? *
When left alone, does this dog usually show any of the following behaviors? (Check all that apply) *

Urinates and/or defecates where they shouldn't Barks, cries, howls for long periods Barks, whines then stops Destroys things Other
Please describe what this dog destroys:
Please describe what behaviors this dog shows:
Is the dog allowed on furniture? *

Yes No
Where does this dog usually sleep overnight? *
What is this dog's behavior when riding in a car?
What commands does this dog know? (Check all that apply) *

Sit Down Stay Shake/High Five Come Heel None Other
Please list what other commands this dog knows:
Does this dog know any special tricks?

Yes No
Please describe:
This dog's energy level is best described as: *

Lazy. couch potato Medium, likes to play, but also relax Energetic, could play all day
When this dog plays, do they typically do any of the following? (Check all that apply) *

Jumps Growls Barks Bites gently Bites hard This dog doesn't play Other
Please describe what they do when they play:
What toys does this dog like? (Check all that apply) *

Balls Frisbee Stuffed Squeaky Tug/Rope This dog doesn't play with toys Other
Please list what other toys this dog likes:
What games does this dog like? (Check all that apply) *

Fetch Tug Chase Wrestling Hide and Seek This dog doesn't play games Other
Please list what other games this dog likes:
Has this dog attended any obedience or training classes? *

Yes No
Please describe the kind of classes and where this dog attended them. *
What type of food/treats does this dog eat? *
Do you feed this dog people food? *

Yes No
Please tell us about this dog's "bad habits" or fears (chewing shoes, jumping on counters or people, hiding during thunderstorms, etc.):
Please tell us anything about your dog that might help us find their perfect future furever/foster home (loves to hike, great with kids, has lived with other pets, etc.):

Dog/Puppy Section 4 - End

Dog / Puppy Section 5 - START
DOG FIVE PROFILE
Dog's Name:
Behavior
Describe this dog's behavior towards family members. *
Describe this dog's behavior with unfamiliar people (visiting adults and children, service technicians, delivery workers) who come to the home. *
Has this dog met any unfamiliar dogs? If so, please describe their behavior when meeting them.
Has this dog ever been walked on a leash? *

Yes No

How does this dog behave while on walks when approaching: (Check all that apply) *

	Little/No Reaction	Friendly	Barks	Growls/ Shows Teeth	Pulls on Leash	Hard to Control/ Has Gotten Away
Unfamiliar Person
Unfamiliar Dog
Cat or Critter
Bicyclists, Joggers, Skateboards

How does this dog behave when you or another family member does the following: (Check all that apply) *

	Little/No Reaction	Enjoys	Afraid/ Avoids	Growls/ Shows Teeth	Snaps/ Bites	No History
Bathe
Brush
Wipe Paws
Trim Nails

Is this dog afraid of anything? If so, what are they afraid of?
Has this dog escaped your property in the last six months? If so, please describe the incident and how the dog escaped:
Has this dog been seen by a veterinarian or groomer? *

Yes No Not Sure
When was this dog last seen by veterinarian? *
Month, Year
Please provide the veterinarian's or clinic's name and phone number:
Please describe how this dog behaves at the veterinarian or groomer. *
Does this dog have to be muzzled at the veterinarian or groomer? *

Yes No Not Sure
Homelife
This dog has lived with: (Check all that apply) *

Men Women Senior Citizens Teenagers Children Toddlers Babies
Has this dog lived with: (Check all that apply) *

Small Dogs Large Dogs Cats Critters This dog has not lived with any other animals
Please describe the breed and age of these animals and how this dog behaves with them: *
Is this dog potty-trained/housebroken?
Where does this dog spend most of their time when someone is home? *
Please describe where this dog spends their time when someone is home:
Where does this dog stay when no one is home? *
Please describe where this dog stays when alone:
How long is this dog left alone? *
When left alone, does this dog usually show any of the following behaviors? (Check all that apply) *

Urinates and/or defecates where they shouldn't Barks, cries, howls for long periods Barks, whines then stops Destroys things Other
Please describe what this dog destroys:
Please describe what behaviors this dog shows:
Is the dog allowed on furniture? *

Yes No
Where does this dog usually sleep overnight? *
What is this dog's behavior when riding in a car?
What commands does this dog know? (Check all that apply) *

Sit Down Stay Shake/High Five Come Heel None Other
Please list what other commands this dog knows:
Does this dog know any special tricks?

Yes No
Please describe:
This dog's energy level is best described as: *

Lazy. couch potato Medium, likes to play, but also relax Energetic, could play all day
When this dog plays, do they typically do any of the following? (Check all that apply) *

Jumps Growls Barks Bites gently Bites hard This dog doesn't play Other
Please describe what they do when they play:
What toys does this dog like? (Check all that apply) *

Balls Frisbee Stuffed Squeaky Tug/Rope This dog doesn't play with toys Other
Please list what other toys this dog likes:
What games does this dog like? (Check all that apply) *

Fetch Tug Chase Wrestling Hide and Seek This dog doesn't play games Other
Please list what other games this dog likes:
Has this dog attended any obedience or training classes? *

Yes No
Please describe the kind of classes and where this dog attended them.
What type of food/treats does this dog eat? *
Do you feed this dog people food? *

Yes No
Please tell us anything about your dog that might help us find their perfect future furever/foster home (loves to hike, great with kids, has lived with other pets, etc.):
Please tell us about this dog's "bad habits" or fears (chewing shoes, jumping on counters or people, hiding during thunderstorms, etc.):

Dog/Puppy Section 5 - END

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