FBFC Surrender/Rehome Form 1. Date 2. Your Name 3. Full Address 4. Primary Phone Number 5. Alternate Phone Number 6. Email 7. What is the best way to contact you? Phone Email 8. If you wish to be contacted by phone what is the best time of day to reach you? morning afternoon evening any of the above 9. FBFC Rescue offers two rehoming options. Which one best meets your needs? Surrender this dog into our care Keep dog with you with FBFC Rescue rehoming assistance Either option would be suitable 10. What is the name of the dog? 11. Breed/Mix 12. Age/DOB 13. Color/Markings 14. Approximate Weight 15. Gender Male Female 16. Is this dog Spayed/Neutered? yes no 17. If not spayed what is the date of last heat? 18. Name & Address of treating veterinarian 19. Is this dog microchipped or tattooed (include number/registry/ dog and owner name registered under) 20. Are you the owner of this dog? yes no 21. If your answer was Yes, how long have you owned this dog? 22. Reason for Surrender? 23. Where did you get him/her? 24. Do you have a breeder contract that includes rehoming conditions? yes no 25. Has breeder been notified yes no 26.This dog is? (check all that apply) housebroken paper trained sometimes has accidents housetraining required 27. Is dog crate trained? yes no 28. Do you walk/ exercise the dog regularly? How often? 29. Where is the dog kept when you are not at home? 30. Where does the dog sleep at night? 31. How many hours a day is the dog left alone? 32. How does the the dog behave when alone? 33. What are the dog’s favourite activities? 34. What training has this dog received? (Choose one or more) Obedience classes Owner trained Individual professional training Training required 35. Known commands. (provide list below) 36. Training Language English French Hand signals Other 37. This dog has lived in home with: Other dogs Cats Birds Other animals 38. Children aged : under 5 5-12 13-16 Older 39. Adults (age bracket and number) 40. How does the dog get along with those listed above? (Describe any issues or concerns) 41. Behaviours:( check those that apply) excessive barking Friendly to people Friendly to other dogs separation anxiety Digs Chews Enjoys car rides Timid/reserved Outgoing jumps on people playful Calm Growls/shows teeth fearful Chases cats/small animals High energy/hyperactive Food motivated Walks well on leash 42. Is the dog protective of its food/toys/treats/family/property yes no 43. How does the dog react to strangers outside and inside the home? 44. Has this dog snapped at or threatened a human or other animal. (describe circumstance) 45. Has this dog bitten a human or animal? (describe circumstance and severity of bite) 46. What is the dog fed, how often and how much? 47. Does this dog have any special needs or health conditions? 48. List any medications or special food/shampoo/care requirements: 49. Is there anything else that you believe we should know about this dog: Submit
