EmailMe Form - Dog Surrender Form

PLEASE TICK *

GDPR Agreement - I give consent for Saving Strays Animal Rescue to store my submitted information so my enquiry can be responded to.

Name of Owner *

First Last

House Number *

Street Name *

Postcode *

Mobile Phone Number *

Email *

Confirm

ABOUT YOUR DOG

Where is your dog from originally? *

Reason for rehoming your dog: *

Name of dog: *

Male or Female? *

Male

Female

Age of dog: *

Is the dog neutered? *

Breed (if known): *

Colour: *

Microchip Information:

Microchip number
Date of insertion

Date the dog was purchased/adopted: *

Is the dog registered with a vet? *

If yes, please provide vet name/address:

Date of last annual vaccinations: *

Date the dog was last flead & wormed. What brand/s were used? *

Weight of dog: *

Is the dog currently taking any medication? *

Yes/No/Unsure
If yes, please provide a list medication here:
Please note any medical conditions that have required treatment by a vet:

Does the dog have any special dietary requirements? *

Yes/No/Unsure
If yes, please provide details of dietary requirements:

What food is the dog currently fed? *

Is the dog house-trained? *

Has the dog lived with children? *

Has the dog lived with cats? *

Has the dog lived with other dogs? *

Is the dog crate-trained? If so, please explain how/when this is used: *

How is the dog around strangers? *

If the dog has ever shown signs of aggression or bitten, please give details (please be honest): *

Please provide us with plenty of details about the dog’s character: *

How does the dog react around other dogs in public areas? *

Please describe the dog’s current walking regime. Is this enough or do they ideally need more? *

Does the dog have established recall to be allowed off lead? *

Has the dog ever caused physical injury (inadvertently or deliberately)? *

If yes, please describe the incident(s) and any injuries in detail:

Can the dog successfully be left alone for short periods of time? *

Yes/No
If yes, how long is the dog used to being left alone?

If you have ever sought advice from a behaviourist, please detail why, who that was and how you got on with implementing their advice: *

What do you think would be the ideal home for your dog? *

If there is any other helpful information you would like to tell us, please do so here:

PLEASE TICK *

By submitting this form, you are agreeing that you have told us the truth about your animal and have not withheld information that could put any persons or animal in danger when placed in our care.

Once you have submitted this form, please send some good quality photos (and video too, if available) of the dog to: info@savingstraysanimalrescue.co.uk

Many thanks!