Assistance Form

SMART Rehoming Assistance Form

Please fill in the form below with as much detail about your dog as possible. Please email photos of your dog to perunsiberians@hotmail.com.
Full Name *

Prefix First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

Area Code Phone Number
E-mail *
Photo of dog *

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.jpg or jpeg Cancel of
Photo of dog

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.jpg or jpeg Cancel of
Photo of dog

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Photo of dog

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Dog's Name
Dog's Breed
Dog Gender

Intact male Intact female Neutered male Spayed female
Is your dog microchipped?

Yes No
Is your dog up to date on vaccines?

Yes, all Yes, rabies only Yes, DHPPV only No
Dog Age
Good with cats?

Yes No Untested
Good with dogs?

Yes Yes, submissive only No Selective
Good with kids?

Yes Yes, older No Untested
Is your dog an escape artist?

Yes Yes, climbing/jumping only Yes, digging only No
Is your dog crate trained?

Yes Yes, night time only Has been crated in the past No My dog cannot be crated My dog prefers wire crates My dog prefers plastic (airline) crates
Is your dog house trained?

Yes Yes, defecation only Yes, urination only Yes, but marks No
Is your dog kept primarily

Indoors Outdoors on a tether Outdoors in a fenced area
Is your dog primarily

A pet A working dog A sled dog
What type of home is your dog seeking?
Does your dog have a bite history with humans?

Yes, just one Yes, multiple No Yes, unreported
Good things about my dog.
Quirks about my dog.
Dog Bio. Please try to follow our format as best as possible and be as thorough as possible. Include things such as daily routine, habits, training known, good traits, bad traits, social skills with dogs and humans, etc.
Failure to provied a bio will result in your dog not being posted for adoption
Is your dog CKC, AKC, or UKC registered?

Yes No
What is the contact information for your breeder? Include your dog's registered name and number.
If yes to the above, I have contacted the breeder to return my dog?

Yes No
Please attach the complete vet file for your dog.

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Alternatively, your vet may email it to us at perunsiberians@hotmail.com Cancel of
I understand that all applications and home visit reports will be sent to me via email. I agree to respond to such emails within 24 hours of receipt. I understand that failure to respond in a timely manner will result in my dog's profile being removed.

Yes No
I understand that once applications are in progress for my dog, I am obligated to release my dog for adoption once the process is started. Withdrawal from rehoming will result in a $500 penalty to be paid to SMART. I may withdraw my dog at any time, without penalty, and rehome privately UNTIL and UNLESS application(s) is/are in progress.

Yes No
I agree to inform SMART when my dog is adopted, if I choose to rehome myself. I also agree to keep SMART updated on whether my dog is still needing a home. I understand that my dog will be removed from the listings after 3 months if I do not keep in contact.

Yes No
My deadline for rehoming is? Reason for rehoming?
I understand that the adoption fee is mine to do with as I please so long as my dog remains under my care while a home is found

Yes No Please keep the adoption fee as a token of my thanks I would like to keep the adoption fee
I understand that if my dog is sexually intact and under the age of 7 at the time of adoption and remains in my care until a home is found, the adoption fee that will come to me after proof of neuter is presented to SMART by the adopter, is less the rebate.

Yes No Please Keep the fee I will spay/neuter my dog before adoption
I understand that the adoption fee goes to SMART as soon as the dog enters physical foster care of SMART

Yes No
I understand that in a foster-to-adopt situation, the adoption fee allocation will be discussed with SMART

Yes No Please keep the fee I would like the fee
Signature

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SMART Rehoming Assistance Form