Surrender Profile and Background Profile & BackgroundToday’s DateFirst NameLast NameFirst NameLast NameAddressAddress Line 1Address Line 2CityStateZip CodeEmailPhone numberBest time to reach you?Can you provide proof of legal ownership? Yes NoHow did you find Doberman Paw Rescue?Date dog must be removed by:What will happen if dog not removed by date given?Reason you are considering surrender~ ~Dog’s NameDate of Birth or AgeSex Malel FemaleColor Black Red Blue Fawn OtherEars Cropped Cropped/Flopped NaturalTail Docked NaturalSpayed/Neutered Yes NoWeightMicrochipped Yes NoTattooed Yes NoAKC Papers Available? Yes NoRabies Tag/Certificate Available? Yes NoAge when you got this dog?Has this dog been bred? Yes NoName and Location you acquired this dog from:Describe dog’s history prior to your ownership:Primary Veterinary Clinic NameAre clinic records available? Yes NoVeterinary Clinic Phone Number*note – you may need to call the clinic to authorize the release of recordsPlease list current medications, supplements and any health issues or injuries for this dog.Current FoodGeneral Feeding Schedule & amounts~ ~Has the dog’s residence changed in the past year? Yes NoDoes this dog have access to a fenced yard? Yes NoThis dog primarily live: Indoors OutdoorsHas this dog ever jumped over a fence? Yes NoIf no fence, how has this dog been exercised and/or kept in the yard?How many hours per day is this dog left home alone?Where is this dog kept when no one is home?Where does this dog sleep?Where is this dog when family is home?Is this dog allowed on furniture? Yes NoWhat is this dog’s signal for potty breaks?Number and Gender of adults living with this dog:Age and Gender of children living with this dog:Do you have other pets? Please tell about them and how they get along:Do you have concerns with this dog meeting new adults? If so, please explain:Do you have concerns with this dog meeting new children? If so, please explain:Do you have concerns with this dog meeting/interacting with other dogs or cats? If so, please explain:~ ~Is this dog housebroken? Yes No Has infrequent accidents Has frequent accidentsDoes this dog walk easily on leash Yes No Could use some workWhat type of collars, harnesses, leashes are used for this dog?When this dog is off leash -how does it behave and respond?What is this dogs favorite toy or activity?Select words or phrases this dog responds to: sit stay down come no this way heel go potty ride walk treat ball toy front here fetch outside wait off drop it get it quiet stop leave it kennel crate bed enough release okay kissesWhich characteristics apply to this dog? can be left alone in the house rides well in car behaves in public swims/wades in water barks rarely or in moderation talks to communicate happy to meet new people chews destructively barks excessively/uncontrollablyf chases bikes or cars digs in yard permits items removed from mouth eats inanimate objects lunges at other dogs comfortable in a crate scratches at doors/windows shares toys handles baths well nails trimmed easily – clipper nails trimmed easily – grinder ears cleanned easily anxious in new situations seems sad or lethargic afraid of thunder/lightening afraid of noises or things melts in the rain snaps when frightened growls respects gates chases cats and crittersWhat do you like best about this dog?Summarize this dog’s overall temperament. (ex – mellow, dominant, clingy, submissive, happy, active, high-strung, shy, anxious, fearful, jealous, protective, playful, silly, affectionate)Do you have any other information or comments, we may have missed in the above, that you feel will help us find a good home for this dog?Has this dog every bitten another animal? Yes NoHas this dog every bitten a person? Yes NoIf you said yes to either bite question, please explain what happen:Please explain any complaints from neighbors, or citations, orders, or complaints from Animal Control or Law Enforcement involving this dog:Let us know what, if any, equipment and or supplies will accompany this dog at transfer. (ex- collar, leash, bed, blanket, toys, crate, medication, food, treats, …) (monetary donations are always appreciated)Are you able to help transport to one of our volunteers? Yes NoIf so, how far?Submit
