Description of Dog Dog's Name *
Gender * Gender *
Male
Female
Is the dog spayed/neutered? * Is the dog spayed/neutered? *
Yes
No
Age *
Breed(s) *
How long have you owned the dog? *
Where did the dog originally come from? *
What was the dog’s role in your family?
Why is the reason you need to rehome your pet? *
General Behavior Check the terms that best describe your dog. * Check the terms that best describe your dog. *
Independent
Dependent
Confident
Protective
Playful
Energetic
Friendly
Silly
Easygoing
Serious
Rough Player
Aggressive
Noisy
Dominant
Submissive
Shy
Nervous
Fearful
Aloof
Quiet
Gentle
Is the dog housetrained? * Is the dog housetrained? *
Yes
No
If yes, how many hours can the dog go without an accident during the day?
Can the dog go without an accident overnight? Can the dog go without an accident overnight?
Yes
No
Is the dog afraid of anything? * Is the dog afraid of anything? *
Yes
No
If yes, please specify.
Does the dog bark excessively? * Does the dog bark excessively? *
Yes
No
If yes, why? (When left alone, At loud noises, etc.)
Is the dog ever destructive? * Is the dog ever destructive? *
Yes
No
If yes, specify when and to what.
Has the dog ever shown aggression toward any person? * Has the dog ever shown aggression toward any person? *
Yes
No
If yes, when (choose all that apply). If yes, when (choose all that apply).
Taking away food/toys
When medicating
Correcting behavior
Sleeping
Grooming
How is the dog aggressive? (Choose all that apply). How is the dog aggressive? (Choose all that apply).
Barks aggressively
Hackles up
Growls
Snaps
Bites
Has the dog ever bitten anyone? * Has the dog ever bitten anyone? *
Yes
No
If yes, when did the bite(s) occur?
Did the bite(s) break the skin? Did the bite(s) break the skin?
Yes
No
What were the circumstances?
How many times has the dog bitten?
How does the dog respond to having toenails trimmed? * How does the dog respond to having toenails trimmed? *
Likes
Tolerates
Dislikes
How does the dog respond to riding in the car? * How does the dog respond to riding in the car? *
Likes
Tolerates
Dislikes
Carsick
How was dog confined in the car? * How was dog confined in the car? *
Loose
In the Back Seat
In a Crate
Behavior with Others Has the dog lived with children? * Has the dog lived with children? *
Yes
No
If yes, how recently?
What ages were the children?
How did the children play with the dog? How did the children play with the dog?
Fetch
Tug of War
Wrestling
Keep-away
Other
How did the dog respond to the children? How did the dog respond to the children?
Likes
Plays With
Tolerates
Growls
Snaps
Bites
Dislikes
Has the dog lived with other dogs? * Has the dog lived with other dogs? *
Yes
No
If yes, please indicate the gender, age and breed for each of the other dogs.
Did the dogs ever fight? Did the dogs ever fight?
Yes
No
If yes, what did they fight over? If yes, what did they fight over?
Attention from owner
Food
Toys
Other
Has the dog lived with cats? * Has the dog lived with cats? *
Yes
No
If yes, what kind of interaction(s) did the dog have with the cat? If yes, what kind of interaction(s) did the dog have with the cat?
Lived inside together
Lived outside together
Slept together
Fought with
Other
Has the dog lived with any animals other than dogs or cats? * Has the dog lived with any animals other than dogs or cats? *
Yes
No
If yes, please specify.
How does the dog respond in an encounter with another dog when on leash? *
How does the dog respond in an encounter with another dog when off-leash but away from home? *
How does the dog respond in an encounter with another dog when off-leash at home? *
Training How many hours per day does the dog spend without humans? *
How many hours does the dog spend per day indoors? *
How many hours does the dog spend per day outdoors? *
Does the dog have access to a dog door? * Does the dog have access to a dog door? *
Yes
No
How is the dog confined when no one is home? *
How is the dog confined when someone is home? *
How is the dog confined when outdoors? How is the dog confined when outdoors?
On leash with a human
Chained or on a cable run
Dog can run loose when outside
Fenced yard
Does the fence completely enclose yard? Does the fence completely enclose yard?
Yes
No
How tall is the fence?
Does the dog ever dig out or jump over the fence? Does the dog ever dig out or jump over the fence?
Yes
No
If yes, how often?
If dog is housetrained, what method was used? If dog is housetrained, what method was used?
Crate training
Paper training
Allowed indoor/outdoor access freely
Was already housetrained
How does the dog “ask to go out?” *
How do you exercise the dog? * How do you exercise the dog? *
Walk
Run
Swim
Fetch
Other
None
How often do you exercise the dog?
How have you tried to stop unwanted behavior? *
Has the dog had any formal obedience training? * Has the dog had any formal obedience training? *
Yes
No
If yes, how long ago?
Where or who did the training?
What commands does the dog know? *
Miscellaneous Is the dog ill, injured, or on any special diet or medications? Explain. *
Where does the dog go for veterinary care? Provide the clinic's name, location and phone number. *
Do you have any additional comments or things you'd like to share about the dog?
Guardian's Information Your First Name *
Your Last Name *
Street Address *
City *
State *
Zip *
Home Phone *
Work Phone
E-mail *
