La'al Marras Rescue Group - Dog Intake Application

La'al Marras Rescue Group - Dog Intake Application

Please fill out in as much detail as possible as it really helps us to find a suitable home or foster space for your dog. If you are applying for intake of more than one dog, please fill out an application for each individual dog. If you struggle with the form format due to disability or additional needs, please email admin@laalmarrasrescuegroup.co.uk, leaving your details and we will arrange a member of the admin team to contact you and go through the form by telephone.
Full Name of Applicant*
Address ( or Last Known Address if currently experiencing homelessness. If you are fleeing violence and it is not safe for you to be contacted at your address please spam the information fields with 'DV' and include alternative contact details)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
Email Address
example@example.com
Dogs Name(s) (Name on Microchip, at Vets and Known As)*
Please include any frequently used nicknames!
Breed (if known or best guess if unknown)*
Sex (Male or Female)*
Date of Birth (if known)

DayMonthYear
Approximate Age *
How long have you been responsible for the dog and where did you obtain the dog from? Please include name of breeder or rescue if applicable. *
Is the dog neutered or spayed? Yes / No*
If your dog is female and unspayed is there any chance they could be pregnant? Yes / No
If there is a possibility, please give as many details as possible, including the breeds of dog your female have locked with and the dates of her last season.
If your dog is female and unspayed, please list date of last season if known.

DayMonthYear
If you have an intact dog are there any medical or behavioural reasons that your dog is not spayed or neutered? Yes (State Reasons) / No
Date of last vaccinations, if your dog is not vaccinated please enter 01/01/2000. If your dog has had first vaccinations but is due a second vaccination, please explain that in the further notes box.*

DayMonthYear
If your dog is not vaccinated please enter 01/01/2000. If your dog has had first vaccinations but is due a second vaccination, please explain that below.
Vaccination Further Notes:
Is the dog microchipped? Yes / No Please include the details of the microchip (number, dogs name on chip and owners name on chip), if the dog is chipped to someone else please explain the reason for this.*
Date of last flea and worm treatment*

DayMonthYear
Please input 01/01/2000 if this is unknown or the dog has not been treated. If you know the month but not the date, please set it as the 1st of the known month.
Name and Dosage of Flea & Worm Treatments if known
Date of last known weigh-in*

DayMonthYear
If your dog has never been weighed or you do not know when they were last weighed, either put 01/01/2000 for no information, or 01/01/accurate year if the day or month is not remembered.
Weight at last weigh-in
Please use KGs if possible. If your dog is considered very under or overweight for their breed, add in a note.
Known allergies or sensitivities
Please include the level of reaction.
Significant Medical History and Current Health Conditions
Current Medication with doses / frequency. (Please include specific grooming products for skin issues)
Permission to contact vets? Yes / No
You will need to contact your vets to give La'al Marras Rescue Group permission to access your pets health record. This is not mandatory, as you can alternatively provide an up to date vet assessment write-up with uploaded supporting photos and douments.
Name of Current / Last Known Vets
Address of Current / Last Known Vets

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Diet (including favourite treats and meal times / amounts)
Does your dog wear a muzzle? If yes, please give details of muzzle type and the circumstances of muzzle use.
Is the dog good with children? Yes /No /Unknown, please add age experience and behaviours.
Is the dog good with strangers? Yes / No / Circumstances Dependant (Please Explain)
Is the dog good with other dogs? Yes / No / Unknown / Circumstance Dependant (Please Explain)
Does the dog have experience with Cats? If so, please explain the circumstances and the dogs behaviour.
Does the dog have experience with Small Furries / Birds? If so, please explain the circumstances and the dogs behaviour.
Does the dog have experience with Horses or Livestock? If so, please explain the circumstances and the dogs behaviour.
Basic Command Training: Please list commands and actions known and performed by the dog, the cue words used and whether hand signals are also used.
Is the dog housetrained? Yes / No / In progress, please include whether the dog signals for toilet breaks or toilets on a schedule etc.
Leash Trained? Yes / No / In Progress (please explain progress made)
Type of Leash / Lead / Collar / Harness etc. worn by the dog, and details of any discomfort from or reactivity to any kind of walking accessory.
Can the dog be walked off lead? Do they have good recall?
How many hours can the dog be comfortably left home alone and how often are they left?
Is the dog crate trained? Yes / No Details of Crate Use or Experience
Any other known behavioural problems? Please describe in as much detail as possible.
Has the dog attended behavioural classes or had input from a behaviourist or trainer? Yes / No Please Give Details.
What are the dogs favourite items and activities? What do they enjoy?
What does the dog dislike or fear?
What are the reasons for rehoming the dog?
What experience does the dog have with formal or informal dog care? This includes Friends, Family or Employed dog-walkers, dog-sitters,groomers, boarders, kennels etc
Current location of the dog and details of who they live with. (Please include approximate age of any children and species / breed / temperament of other animals and the level of interaction the dog has with them.)
How far is the dog able to comfortably travel for assessment, fostering or adoption?
In miles or minutes in a car. Please include any experience your dog may have with public transport.
Are you able to transport the dog yourself for assessment and initial placement (foster or adoption) or cover / contribute to the fuel costs of hiring a third party volunteer transport network? Please state amount you are able to contribute.
The Volunteer Transport Network is drivers from all over mainland Britain that volunteer their time and energy to get rescue dogs safely from A to B. They charge a set amount per mile to cover their fuel costs which is around 25p-35p depending on the driver. We endeavour to find the most time and cost effective option. All monies are paid directly to the transporter that volunteers for the transport run, not to La'al Marras Rescue Group.
Please share any additional information that may help us understand the dogs needs.
Please send any photos and videos of your dog that are a good, fair representation of their temperament, health and character. Please send all additional information outside of the form to:

admin@laalmarrasrescuegroup.co.uk

Subject: YOUR FULL NAME / DOGS NAME PROOFS
Please tick any items that will be sent with your dog: Please note that this will not affect intake decisions in any way other than to help aid planning and preparation.
There are perfect homes out there for every dog so please don't worry if your dog needs a little extra help with training or has higher upkeep costs, this will not prevent intake.
File Upload

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I blank confirm that I am the legal owner of blank , and that my dog has never broken the skin or caused bleeding to any human or animal. I confirm that all information given in the intake application is as accurate, honest and fully explained to the best of my ability.
Signature:
Date

MonthDayYear
Date
If you are unable to fill in the disclaimer due to a bite history please make admin aware of this immediately and please share the circumstances of the bite history below
La'al Marras Rescue Group is a volunteer-led dog rescue group. Submission of this form does not guarantee that the group will be able to take responsibility for your dog. This form is not a transfer of ownership or responsibility, and does not create any legal obligation on the part of La'al Marras Rescue Group. Each case is assessed individually based on urgency, availability of foster space, and the welfare needs of the animal.
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