This form is for people who need to rehome their dog. Submitting this form does not guarantee that Happy Dog Rescue will take your dog into our foster program or assist with the rehoming. It is merely the first step for you to tell us about your dog's temperament and why you need to rehome it.

Please use the tab key to move from field to field. Incomplete forms will not be processed. If you accidentally submit an incomplete form, please start over and submit a new one.

If you have digital pictures of your dog that you would like to submit along with this questionnaire, please resize them to no larger than 200k in size and email them to SaveTheDogs@rcn.com. Please put your name and the dog's name in the subject line of the email.

We will be in touch within 24 hours of receiving this questionnaire.

Dog's Name: Breed/mix:
Age: Weight: Sex: Female Male
Altered (spayed/neutered)? Yes No
Date of last rabies vaccination:
Date of last distemper combo vaccination:
Date of last lymes vaccination:
Date of last heartworm test: Results:
On heartworm preventative? Yes No
Date of last lymes test: Results:

PLEASE NOTE: Should Happy Dog Rescue have room in foster care and evaluate this dog as acceptable for entrance into our foster care program, you will need to provide proof that the dog is up to date on vaccinations (rabies, dhlpp, bordatella, lymes), has been heartworm/lymes tested negative within the past month or has been on heartworm preventative meds, and is spayed or neutered. We do not accept surrenders into our foster care program that are not up to date on vaccinations, altered, and heartworm/lymes negative. If not up to date on all of the above, you will need to have this done prior to surrendering the dog to the care of HDR. Please check this box indicating that you have read, understand, and agree to this paragraph.

Why do you need to find a new home for this dog?
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How much time do you have before this dog MUST be out of your home? If within the next week, it is doubtful we will be able to help you.

Is this dog in any physical danger at the present time? (Explain)
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To your knowledge, has this dog ever bitten anyone?
No Yes - describe circumstances (please be as detailed as possible):
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Temperament/personality traits. How does this dog behave around adults, children, dogs, cats, strangers? What is the dog's energy level like? Is the dog housebroken? Does it walk well on a leash? etc.
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Any fear or aggression issues? (Explain)
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Any health issues? (Explain)
.

Preferred type of home for this dog and why:
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Name, address, phone number, and fax number of your current vet:
Vet Name: Address: City/St/Zip: Phone: Fax:

What supplies (if any) will you surrender with this dog?
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Amount you will donate to our rescue for the care and feeding of this dog while it is in foster care:

Owner's Name: Co-Owner's Name:
Address: City: State: County:
Email address (mandatory): Evening Phone #: Cell:

Should we have a foster home interested in fostering your dog, we will contact to arrange a meeting so we can evaluate the dog. We will need to see the dog's current vetting records during that meeting. In order to transfer ownership of the dog to HDR, you will need a health certificate from your vet. Please do not arrange to get that health certificate until we have met and evaluated your dog in person and agreed to take the dog into our foster care program.

By signing below, I hereby certify that I am the owner of this dog; that this dog is free and clear of ownership by any other person, shelter, or rescue; that the information submitted on this questionnaire is accurate and complete; and that I have not withheld any information regarding my dog's health or temperament.

Important: Please read this paragraph before checking the box. By checking this box, I am asking Happy Dog Rescue to contact other rescues about my dog in the event that Happy Dog Rescue is unable to assist me with the rehoming. I understand that this means that my contact information will be emailed to other rescues and may also be crossposted on the internet. DO NOT check this box if you do not want your contact info shared in this manner.

Signature of Owner: Date:

Signature of Co-Owner: Date: