Rescues & Rehoming

Rescues & Rehoming
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone*

Area CodePhone Number
E-mail*
Who lives in your household (or is a regular visitor)?*

AdultsChildrenPet(s)Other
Children's ages:
Tell us about your pet(s):
Please indicate what issues you are NOT willing to take on with a rescue:

Health Issues (Hip dysplasia, cataracts, luxating patellas, etc.)Temperament IssuesOther
Please indicate what issues you are NOT willing to take on with a rescue: *

Health Issues (Hip dysplasia, cataracts, luxating patellas, etc.)Temperament IssuesOther
Do you understand and agree that rescues are sometimes not suitable candidates for shipping and must be picked up in person (if applicable)?*

YesNo
Please indicate any previous experience with dogs and rescues.*
Please indicate what activities you wish to do with your potential rescue and a bit about your daily household routine.*
Please list any requirements you have regarding your dog including anything aesthetic.*
Should be Empty: