| Owner Admit Form One of our Representives will Email you as soon as we recieve this Application Please do a cut & paste & email to us Owners Name Owners Address Owners Phone Number Email Address: Dogs Name Age Years Months Male/Female: Spayed/Neutered Breed or type of dog: How long have you had your dog? How did you acquire your dog? The dog get along with other Dogs? Has the dog bitten anyone? What food you are feeding your dog? How often in a day How much Why do you have to give your dog up Behavior Please underline which apply: Quiet Shy Easy Going Couch Potato Separation Anxiety Loud Chews Is Protective Plays Rough Likes to be Indoors Digs Whines Aloof Dominant Likes to Run Needs Confinement Timid Roams Growls Escapes Submissive Slinks Outgoing Likes People Excessive Barking Afraid of Loud Noises Submissive Wetter Barks at objects or people when they are approaching you Yes?No Please describe your dogs personality:: Is your dog housebroken? YES NO Is your dog destructive when left alone? YES NO How often does your dog ride in the car? Does he/she like it? YES NO Is your dog housebroken? YES NO Is your dog destructive when left alone? YES NO Does your dog bark at the door when some knocks or rings the door bell? YES NO LIVING SPACE Does your dog live: Indoors only In/Out Outdoors Only Where was your dog kept durning the day? When not at home At Nite What type of confinement do you have? If you have a fence what type is it? Does your dog jump fences or escape the yard? YES NO Does your dog get up on the fence & peek over? YES NO Does your dog climb the fence or jump over it or both?___________ Does you dog dig under the fence? YES NO In order for us to be able to place your dog in a suitable home for his needs we would like you to describe your dog in your own words. Such as Likes, Dislikes, Any Tricks? Special Treats? If you dog has bitten someone was it a child/adult/both what happened? Anything else we should know About? Medical Will need all the medical proof that you have for your dog. Name & Dates of All last Shots given: Type of Shot DateGiven: Type of Shot Date Given: Type of Shot Date Given: Heartworm Check: Y N Date: / / Positive/ Negitive If Possitive what medication is dog on & dosage: Spayed/Neutered: Vet Name: Vet Address: State: Zip: Vet Phone: Surgeries Surgeries & Dates: What for? Surgeries & Dates: What for? Wormings Wormings: Date: / / What for? Who did it? Medicine used: Wormings: Date: / / What for? Who did it? Medicine used: Other Medical we should be aware of? |
 |
 |
 |
 |
 |
 |