Online Surrender Form

Online Surrender Form:-

New Dawn Malinois Rehoming Dog Surrender Document
Although we do not have the capacity or the ability to take in every dog brought to us, by filling out this application you are giving your dog the best chance of a future family. Please be honest with your answers, what may be a problem for you, may

not be for another family. We will use this information to help match your dog with a new family and help make the transition into a new home as smooth as possible for your dog.
Phone numbers
Email address:
Reason you are surrendering your dog
Dogs Name
Dogs Birthdate
Month Day Year
Date
Where and When did you get your dog
Date of last vaccination:
Does your dog have any health problems / injuries?
If yes to health problems/ injuries, please describe.
Describe your home Very active / Active / Quiet
Do you consider your dog: High Energy / Medium energy / Couch potato?
What would best describe your dog? Easy going / Constant companion / Obedient Destructive / Friendly / Lap dog / Quiet / Talkative / Other:
Is Your dog crate trained? Yes / No If yes, please give approx. time left alone?
Is this dog protective of belongings?
What would best describe your dog? Easy going / Constant companion / Obedient Destructive / Friendly / Lap dog / Quiet / Talkative / Other:
What do you feed your dog? How Often?
Is Your dog housebroken? Yes / No If no, please describe issues
Has your dog lived primarily indoors or outdoors? If outdoors, describe:
Has your dog lived primarily indoors or outdoors? If outdoors, describe:
Is Your dog crate trained? Yes / No
If yes, please give approx. time left alone?
How is your dog with strangers? Everybody's friend / Runs and hides / Shy / Barks at first then okay / Good once he/she knows them / Will bite /
Has your dog lived with or been around other dogs? Yes / No If yes, what sizes, breeds, describe their behavior?
Has your dog been around other small animals, e.g., cats, rabbits, hamsters, etc. ? Yes / No If so please describe how he/she is around them? E.g., Doesn't bother, cuddles, is playful, or aggressive, or chases
What is your dog afraid of? (please circle as appropriate) Thunder / 'Rain / Vacuum / Fireworks / Baths / Toddlers / Men / Women / Strangers / Cats / Other?
Does your dog have separation anxiety?
Is your dog destructive? Y / N if so, what has it destroyed?
About the Dog: With other PeopleHas your dog been around children? Yes / No
Has your dog been around children?
If so, what age of children? 0-5 / 6-9 / 10 and older. What was your dog's reaction towards them?
Has your dog ever been aggressive toward - snapped, growled at, or bitten a child? If yes, how many times and what were the circumstances?
Has your dog ever been aggressive toward, snapped, growled at, or bitten an adult? Yes / No If yes, how many times and what were the circumstances?
How is your dog with strangers? Everybody's friend / Runs and hides / Shy / Barks at first then okay / Good once he/she knows them / Will bite /
How does your dog do at the vet? Is it aggressive toward the caregiver? Y / N
Is your dog ok with getting its nails trimmed Y / N
Does it need to wear a muzzle Y / N
Would your dog run away if let off the lead? Y / N
Does your dog know any commands or have you done any training? Or Classes, If so please list and describe
Has Your dog ever harmed/injured/bitten another dog? In the home or Outside? If yes please describe the circumstance
In the garden, has your dog ever jumped a fence? Y / N If so what height: Has your dog ever climbed or dug under a fence? Y / N
Has your dog ever harmed, bitten, or chased any livestock, e.g. sheep, cows? If yes please describe the circumstances
How does your dog travel? (please circle as appropriate in the back seat / Crate / Boot. Does it get car sick? Y/ N
Please be as honest as possible as this will help us with his assessment, any training, and our ability to rehome him/her in the future, continue in the box below if necessary
Additional information
People who wish New Dawn to help with the re-homing of their dogs are asked to make a minimum donation of £50.00 towards administration fees. This fee can be waivered in extenuating

I am/ am not able to make a contribution of £50.00 towards the administration fees. if not please give what you think are the extenuating circumstances?

Ihereby certify that I am the rightful owner/keeper/caretaker/custodiar of the Dog(s) who is/are

the subject of this Dog Surrender Form, hereinafter referred to as "the Dog." I hereby surrender any and all property rights to the Dog. I certify that no other person has a right of property to the Dog. I understand that by surrendering my property rights to the Dog, the Dog may be transferred into the custody of New Dawn Malinois Rehoming to find a suitable adoption home for my Dog and I accept their terms and conditions.

I understand that once I relinquish the Dog, the Dog will not be available to be returned.

I further certify that | have read and understand the terms of this Dog Surrender Form
I {insert name}
Of
{insert address
Postcode
Print name
Signature

Clear
Date
Month Day Year
Date
www.facebook.com/newdawnmalinoisrehoming admin@newdawnmalinoisrehoming.co.uk
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Online Surrender Form

Online Surrender Form:-

New Dawn Malinois Rehoming Dog Surrender Document