Upload #1 of 3 Recent Photos of Your Dog:
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What is the Primary Reason You Want to Surrender Your Dog?
How Does Your Dog Alert You if it Needs to go Outside?
How Many Meals Does Your Dog Have Per Day and When?
Heartworm Preventative Last Test Date:
Last Vaccination Dates for Annual DA2PP, Rabies, Bordatella, Corona:
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Monthly Preventative Medicines Given (type, brand, day of month for each)
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Your Veterinarian's Name and Phone Number :
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Dog's Color(s):
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Spayed/Neutered?:
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Yes
No
Dog's Gender:
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Male
Female
Dog's Breed:
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If There Are Children in the Dog's Current Home, What Ages?
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Which of These Does Your Dog Know and Like?
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Children
Strangers
Baths
Grooming
Nail Trim
Swimming
Fetch
Walking
Dog Park
Boating
Car Rides
Travel
None of These
City:
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Street Address:
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Name:
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Email:
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Daytime Phone Number:
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Thank you for contacting us! We will respond to your request as soon as possible.
Date Available for Surrender
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Date Signed (mm/dd/yyyy)
Signature (Typed Name) and Legally BInding:
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Please Provide Additional Comments/Details You Feel May Assist Uus in Placing Your Dog:
Upload #3 of 3 Recent Photos of Your Dog:
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Upload #2 of 3 Recent Photos of Your Dog:
We were unable to upload your file. Please ensure your file is 10MB or smaller in size.
Please Provide Additional Details of Positive or Negative Behavior for the Next Owner:
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Has Your Dog Displayed Fear of:
Strangers
Thunder
Noise
Other Dogs
Has Your Dog Ever Bitten a Person or Other Animal?
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Yes
No
Has Your Dog Ever Snarled or Snapped at a Person or Animal?
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Yes
No
Which Positives Describe Your Dog?:
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Crate Trained
Housebroken
Obedience Trained
Comes When Called
Walks on Lead
Fetch
Does Tricks
Other
None of These
Which of These Commands Does Your Dog Obey?:
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Sit
Stay
Heel
Down
None of the Above
Dog's Nickname(s) - if any:
Dog's Name:
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How Was The Dog Acquired?
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Breeder
Pet Store
Rescue Group
Animal Shelter
Gift
Stray
Other
Dog's Age When Acquired (years, months):
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State:
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Cell Phone Number:
Surrender Request Form
The Grayter Good Weimaraner Rescue
Where Does Your Dog Stay if the Family Travels?
Where Does Your Dog Stay When The Family is Asleep?
Where Does Your Dog Stay When No One is Home?
How Many Hours Is Your Dog Used to Being Alone?
Describe Current Status Plus Past Evaluation, Date and Treatment of Each Issue:
All Current or Prior Physical Health Issues:
Eyesight
Hearing
Teeth
Growths
Skin
Fur
Scars
Underweight
Overweight
Illness
Injury
Disease
Surgery
Which Negatives Describe Your Dog?
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Barks Frequently
Inappropriate Chewing
Bites
Digs up Lawn or Garden
Growls Over Food or Toys
Jumps on People
Inappropriate Urinating/Not Housebroken
None of These
How did you find The Grayter Good Inc?:
Strangers
Thunder
Noise
Other Dogs
Describe Your Dog's General Temperament?
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Dog's Age (years, months):
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Dog's Weight:
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Number of Adult Residents in the Dog's Present Home?:
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Zip Code:
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