Canine Return and Surrender Profile

Canine Return and Surrender Profile

Once you have completed the pet's personality profile, you will receive the link to book your appointment for an owner surrender at the Idaho Humane Society.
Dog and Household Information
Did you adopt this dog from the Idaho Humane Society?

Yes, less than 30 days ago.Yes, more than 30 days ago.No
Please select one of the following. I am interested in surrending my pet due to the following:*
Name*

First NameLast Name
Owner's Name: *
Address (PO Boxes not accepted)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner's City and State where residing: *
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What is your dog's name?*
What is your dog's gender?*

MaleFemale
How old is your dog?*
What is the breed of your dog?*
Is your dog spayed or neutered?*

YesNoDon't know
Where did you get this dog from?*

This shelter (Idaho Humane Society)Friend/RelativeNewspaper/WebsiteFound/StrayBreederPet StoreOther shelter/rescueOther (please describe)
If from other shelter/rescue, please provide name: *
How long have you owned this dog?*
Please provide more information with why you surrending your dog?*
If our staff can provide resources or assistance to help you, would you consider keeping your dog?*

YesNo
If IHS determines that your pet is not a candidate for adoption through our shelter, would you like to be notified?*

YES: and I will reclaim my pet within 48 hours.YES: I would like to be contacted about euthanasia, and I am unable to redeem my pet.NO: I do not want to be contacted if my pet is not a candidate for adoption.
Typical Behavior

Please describe your dog's usual behavior
Including yourself, how many people of the following ages live in your house? Please list the ages of MEN inside the home:*
Please list the ages of WOMEN inside the home:*
Please list the ages of children that are BOYS inside the home:*
Please list the ages children that are GIRLS inside the home:*
What other animals did your dog live with?*

No other animals in the householdDogsCatsChickens/PoultryRabbits/Small AnimalsDomestic BirdsHorsesLivestockOther (please describe)
How does the dog interact with these animals? *
How does your dog usually behave toward MEN your dog KNOWS:*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward WOMEN your dog KNOWS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward CHILDREN your dog KNOWS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR MEN*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR WOMEN*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR CHILDREN*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward DOGS your dog KNOWS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward CATS your dog KNOWS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward OTHER ANIMALS your dog KNOWS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR CATS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR DOGS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually behave toward UNFAMILIAR OTHER ANIMALS*

Never encounterFriendlyAfraidShows teeth/growlsSnapsBitesOther (please describe)
How does your dog usually react when an unfamiliar person approaches or enters the yard or house?*

FriendlyAfraidBarksShows teeth/growlsSnapsBitesOther (please describe)
Does your dog usually have "accidents" in the house?*

NoYes, please specify how often:
Would you describe these accidents as:*

MarkingNot fully housetrainedBehavioral (fear or excitement)Other (please describe)
Where do you leave your dog when it is home alone?*

Inside the house (runs free)Inside the house (in crate)Inside the house (confined to 1-2 rooms)Inside the house with access to yard via dog doorOutside the house (runs free in the neighborhood)Outside the house (runs free in the yard)Outside the house (in kennel)Outside the house (tied)Other (please describe)
Describe your yard (check all that apply)*

Fully fenced, 6+ foot fenceFully fenced, 6 foot fenceFully fenced, 4 foot fencePartially fencedUnfencedElectric fenceChain linkWoodVinylIronOther (please describe)
How long is your dog left alone, without people, during each day?*

Never1-3 hours4-8 hours9-12 hoursOver 12 hours
Does your dog show signs of stress when left home alone? (for example: panting, drooling, destructive behavior, attempting to escape, vocalizing). If yes, please describe the behavior. ”*

NoYes
Please describe the stress-behavior your pet exhibits when left alone:*
Where does your dog usually sleep overnight?*

CrateFloorDog bedCouchOwner's bedOutdoors (loose in yard)Outdoors (kennel)Other (please describe)
Tell us about your dog's "bad habits"*

Jumping UpMouthyPlays roughlyExcessive barkingDigs holesDestructiveChases cars/motorcyclesChases cats/small animalsChases livestockChases bicyclesJumps fences (please specify fence height)Barks at things when on leashGrabs food/items off counters/tablesChases peopleUrine markingRuns awayBarks at things through fenceEscapes (please specify how often)Other (please describe)
Please specify fence height that your dog jumps:*
Please specify details of how often your dog escapes?*
Is your dog allowed on furniture?*

YesNo
What commands does your dog know?*

SitDownStayComeHeelShakeNo commands knownOther (please describe)
Has your dog attended a formal obedience training class?*

NoYes (please provide trainer's name)
Is your dog scared of anything? (i.e. fireworks, thunder, certain objects)*

NoYes (please describe their reaction)
Does your dog have problems riding in the car?*

Don't knowNoYes (please describe)
Describe how you provide physical exercise for your dog (please check all that apply)*

Play fetchWalk on leashWalk off leashTake to dog parksDoggy daycareRun togetherPlay tugTake swimmingLeave in backyardWrestleHuntingOther (please describe)
How would you describe your dog's personality? (please check all that apply)*

FriendlyAffectionateLovingPlayfulQuietCuddlyTimid/ShyCalmAnxiousActiveHyperactiveProtectiveIndependentConfidentSubmissiveFearful
What is your favorite thing about your dog?*
Aggressive Dog

Please list any behavior that has ever happened.
Has your dog ever fought with another dog?*

YesNoDon't know
Has your dog ever injured another dog?*

YesNoDon't know
Has your dog ever attacked another domesticated animal species (cats or livestock, but not "small pets" like hamsters, guinea pigs, etc.) resulting in injury or death to another domesticated animal?*

YesNoDon't know
Has your dog ever inflicted a bite to a person that has broken skin?*

YesNoDon't know
Has your dog ever shown aggressive behaviors towards MEN?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Has your dog ever shown aggressive behaviors towards WOMEN?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Has your dog ever shown aggressive behaviors towards CHILDREN?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Has your dog ever shown aggressive behaviors towards VETERINARIANS or GROOMERS?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Has your dog ever shown aggressive behaviors towards other DOGS?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Has your dog ever shown aggressive behaviors towards OTHER DOMESTICATED ANIMAL SPECIES (cat, livestock, etc.)?*

Shows teeth/growlsSnapped or lunged atBite (did not break skin)Bite (broke skin)None of these
Please explain the circumstances of the snap or bite. If you checked more than one bite in the answers above, please explain the circumstances of every snap or bite.*
Was the aggressive behavior over food?*

MenWomenChildrenDogsNot Applicable
Was it over bones, rawhides, or chews?*

MenWomenChildrenDogsNot Applicable
Was it over toys?*

MenWomenChildrenDogsNot Applicable
Was it over stolen objects?*

MenWomenChildrenDogsNot Applicable
While breaking up a dog fight?*

MenWomenChildrenDogsNot Applicable
When the dog was in severe pain?*

MenWomenChildrenDogsNot Applicable
Was it when the dog was disturbed while sleeping or resting?*

MenWomenChildrenDogsNot Applicable
Was it when an adult or child handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc.)?*

MenWomenChildrenDogsNot Applicable
Was it when an adult or child entered the house or yard?*

MenWomenChildrenDogsNot Applicable
Was it when an adult or child approached and reached toward the dog?*

MenWomenChildrenDogsNot Applicable
Medical History
Did your dog receive regular veterinary care?*

YesNo
Please list the contact info (name/phone) for your vet so we may request veterinary records (if needed): *
Does your dog have any past or present medical conditions, medication, or special dietary requirements?*

NoYes (please describe)
Please feel free to tell us any additional helpful information about your dog:
Please feel free to upload a photo of your pet (optional)

Cancelof
Should be Empty:

Canine Return and Surrender Profile

Dog and Household Information

Typical Behavior

Aggressive Dog

Medical History