Incoming Dog Profile - KW

  • Incoming Dog Profile - KW

  • ID# 

    ____________________________________________________________________

    (Please leave this field blank. ID# will be added once the form is submitted).

  • Date*
     - -
  • Format: (000) 000-0000.
  • Is your dog spayed or neutered?*
  • Is your dog Microchipped or Tattooed?*
  • Do you have current vaccine records for your dog?*
  • When was the last time this dog was seen by your Veterinarian?*
  • Describe this dogs behaviour while at the Vet Clinic*
  • Has your dog ever worn a muzzle?*
  • Where did you get this dog?*
  • How many hours per day is your dog normally left alone?*
  • Where is the dog kept when no one is home?*
  • What does this dog do when left home alone? Check all that apply.*
  • Does this dog require grooming?*
  • If this dog requires grooming, who does it?
  • If this dog requires grooming, how does the dog react?
  • Who trims the dogs nails?*
  • How does the dog react to their nails getting trimmed?*
  • Is there any body part that your dog does not like you to touch?*
  • Is your dog afraid of anything that you are aware of?*
  • What does this dog do if you try to take something away from them?*
  • Where does your dog sleep?*
  • How would you describe this dog with the adults in the home?*
  • How would you describe this dog with the children in the home?*
  • How does this dog interact with visitors?*
  • Are there other pets in the home?*
  • How does this dog interact with dogs in the home?*
  • What does this dog do when seeing dogs on walks?*
  • How does this dog react when seeing wildlife ie) squirrels, while on a walk?*
  • Have you taken this dog to the dog park/places to play with other dogs?*
  • How does this dog interact with cats indoors?*
  • How does this dog react when seeing a cat outside while on a walk?*
  • What do you walk this dog on?*
  • Has this dog ever worn a shock collar?*
  • If so, how has the shock collar been used? Check all that apply.
  • Has this dog ever worn a prong collar?*
  • If so, how has the prong collar been used? Check all that apply.
  • What type of food is this dog being fed?*
  • What toys does this dog enjoy? Check all that apply.*
  • Do they destroy toys?*
  • How does this dog react during car rides? Check all that apply.*
  • How does this dog enjoy swimming?*
  • If this dog has bitten, has it even drawn blood?
  • If this dog has bitten, has it ever resulted in a trip to the hospital/doctor?
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  • Was a photo provided?*

  • The Humane Society of Kitchener Waterloo & Stratford Perth's Euthinasia Policy.
    The Humane Society of Kitchener Waterloo & Stratford Perth is dedicated to ensuring no healthy adoptable animal is euthanized, thereby increasing the live release rates of pets in its care. It is our mandate to exhaust all efforts before euthanasia is considered. Every animal’s life deserves a conversation. 

    Euthanasia may be considered as a last resort for unhealthy and untreatable animals. 

  • If this animal should not be considered an adoption candidate for behaviour or medical reasons, would you like to be informed prior to euthanasia?*

  • Please initial to verify that you understand the question above. Should you select "No" to being notified about euthanasia, in the previous question, you WILL NOT be contacted in the event that euthanasia has been decided.

  • By signing below, you the owner, understand that you are relinquishing ownership of the dog; all decisions pertaining to the dog will now be made by The Humane Society of Kitchener Waterloo & Stratford Perth; the possibility that a decision may be made to euthanize and if that decision is made, you have the option to be notified. You also understand that if you selected “NO” to being notified about euthanasia, you will not be contacted, in the event that euthanasia has been decided. 

  • Date*
     - -
  • Staff Signature

                        

     

    		 Date
    ______________________________   ______________________________

  • Note: The Humane Society of Kitchener Waterloo & Stratford Perth at no time will sell, lend or give your personal information to any group or person. This includes List Brokers, Mail Order Businesses, Telemarketers or other companies who would sell their services or products. All information is stored in a secure manner in accordance with the Personal Information Protection and Electronic Documents Act. 

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