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- How did this dog come into your care?*
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- Have you contacted the shelter/rescue where you adopted this dog from?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Dog's Sex*
- Is this dog altered/spayed/neutered?*
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- Why do you need to surrender this dog to BHS? (please check all that apply)*
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- Has this dog ever bitten a person?*
- Has this dog ever bitten another animal/pet?*
- Has this dog ever been bitten by another animal/pet?*
- Has this dog ever bitten and it broke the person's skin?*
- Has this dog ever bitten to a point where it drew blood from the person?*
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- Please select all that apply to the circumstances of this dog's bite history.*
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- On average, how much physical exercise does this dog receive while in your care?*
- On average, what type of exercise does this dog typically receive while in your care? (check all that apply)*
- How is this dog contained when outdoors? (check all that apply)*
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- How long is this dog left alone in your home on a daily basis?*
- Where is this dog left when home alone?*
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- Where does this dog sleep at night? (check all that apply)*
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- Does any of the following frighten this dog? (check all that apply)*
- What are this dog's favorite types of toys? (check all that apply)*
- How does this dog typically behave when left alone in the yard? (check all that apply)*
- How many times has this dog escaped your yard?*
- If your dog escapes your yard, what typically triggers them? (check all that apply)*
- If your dog escapes the yard, how would they do it? (check all that apply)*
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- Does this dog currently live with children under the age of 12 years old?*
- How do your children interact with your dog? (check all that apply)*
- How does your dog behave around your children? (check all that apply)*
- Do children visit your home regularly?*
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- What types of animals has this dog lived with while in your care? (check all that apply)*
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- Is this dog house-trained?*
- If this dog has accidents in the house, when do they typically occur? (check all that apply)*
- What was your typical response to this dog having accidents in the house? (check all that apply)*
- Has your dog had any obedience training?*
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- Have you used any kind of electric/shock collar on your dog?*
- If yes, what is the electric collar used for? (check all that apply)*
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- How do you typically respond when your dog misbehaves? (check all that apply)*
- Please check all verbal cues this dog responds to.*
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- While in your care, has this dog been to a veterinarian?*
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- What was the last vet for this dog visit for? (check all that apply)*
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- How does your dog behave at the vet? (check all that apply)*
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- Should be Empty: