Re-Homing Your Dog

Re-Homing Your Dog

Anthem Pets Animal Rescue
Dog's Name *
Sex *
Spayed / Neutered? *
Dog's Age *
Microchipped? *
Breed *
Full Name *

First Name Last Name
Address *
City, State *
Zip *
E-mail *
Phone Number *

Area Code Phone Number
Our service area is the Anthem, Tramonto and South New River Area. Please see the map here. SERVICE AREA. If you are outside of this service area we may not be able to accept your cat. We are a foster-based rescue and do not have a shelter.
Why are you surrendering this dog? (Please provide as much information as you can.) *
How long have you owned the dog? *
How many homes has the dog had? *
Where did you get the dog? *
Has the dog scratched or bitten a person in the last ten (10) days? *

Yes No
In what city?
If yes, did the bite break the skin?

Yes No
Has the dog ever *

Bitten Scratched Lunged or attacked None of these
If Yes, who was bitten:
Was Animal Control involved?

Yes No
Please explain the circumstances:
Dog's Vet:
Phone:
Is the dog up-to-date on Vaccinations? *

Yes No Unknown
Please list any past or present injuries, treatments or other medical history
Please Check all the following that describe your dog *

Very active Couch potato Barks a lot Quiet Playful Friendly Fence Jumper Shy Likes to be touched Affectionate Fearful Independent Protective Always at your side Indoor dog Outdoor dog Nervous House-Trained Crate-Trained Likes men Likes women Worked livestock Used for hunting Separation anxiety Digger
Has the dog lived with children? *

Yes No
If yes, what ages?
Would you recommend your dog live with children in the future? *

Yes No
Has the dog lived with cats? *

Yes No
Would you recommend your dog live with other cats in the future? *

Yes No
Has the dog lived with dogs? *

Yes No
Would you recommend your dog live with dogs in the future? *

Yes No
What are the dog's favorite activities or objects? *
What does the dog dislike or fear? *
Where is the dog kept during the day? *
Where does the dog sleep at night? *
Is there anything else a future owner should know about this dog?
My signature below certifies that I am the owner of the animal described above. I also authorize the release of any veterinary records regarding the animal should a suitable adoptable family be found. I certify that to the best of my knowledge I have disclosed all information about the animal concerning health, behavior, history and anything else that may affect the safe placement of the animal in a new home, and that all statements made above are true and corrrect.
What is the deadline to re-home your pet *
Photo of pet *
You can upload a 2nd photo of your pet

Upload a File

Cancel of
There is a surrender fee for your dog. If we accept the dog for rehoming, you will be responsible for paying this fee.
NOTE: Occasionally users of mobile devices or tablets will experience errors when completing the form. If you are unable to submit, please email Rescue@AnthemPets.org.
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