Surrender Form - Oregon Dachshund Rescue Inc.
Your Contact Info
First and Last Name
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Email
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Phone
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General Information
Name of dog
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Sex
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Male
Female
Age
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Color
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Coat color and style
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Weight
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Please list any impairments (blind, deaf, etc.)
What city is the dog in right now? Who is the dog residing with?
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Reason for surrender?
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Did the dog come from another rescue?
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Yes
No
Unknown
If the dog came from another rescue, which one?
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Medical Information
Is dog spayed/neutered?
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Yes
No
Unknown
Are Veterinary records available?
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Yes
No
If so, complete vet records can be faxed to (360)225-7911, or attached by using the upload button below. You could probably contact the vet and request them do this for you. They will not release the information to us with out your approval.
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Has the dog been to the vet recently?
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Yes
No
Unknown
Is the dog up to date on all immunizations (Rabies, DHPP, Bordatella)?
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Yes
No
Unknown
When was dog last wormed?
When was last flea treatment?
What is the condition of the dog's teeth? Please include any recent dental work or cleaning.
Please list any allergies or skin issues
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Please list any health conditions and medications below
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Behavior
Is the dog friendly with children?
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Yes
No
Is the dog friendly with cats?
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Yes
No
Is the dog friendly with other dogs?
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Yes
No
Is dog leash trained?
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Yes
No
Please explain any behavioral issues the dog has
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Has the dog received any obedience training?
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Yes
No
Does the dog know basic commands (sit, stay, no, etc)?
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Yes
No
Is the dog house trained?
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Yes
No
Piddle pads
Please let us know what activities the dog particularly enjoys.
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Please let us know any humorous behaviors or stories.
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Please upload a photo of your pet
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Please refer to www.odr-inc.org/surrender for the guidelines to a successful surrender. Oregon Dachshund Rescue, Inc. is a 501 (c)3 and relies entirely on donations to care for our dogs. We ask for a $100 surrender fee. Are you able to donate $100 for the surrender.
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Yes
No
In the event that we cannot take in your surrender due to being overfull or the like, we will still help you place your dog using our network to share, in which event YOU will be the contact, not Oregon Dachshund Rescue, Inc. Is this ok with you?
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Yes
No
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