First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Work Phone
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Cell Phone*

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DOGS: We are currently do not have the resources to take in dogs with a history of aggression towards humans or other dogs.

What is the name, age and gender of the animal you wish to surrender?*

What breed is the animal?*

What is the reason you wish to surrender the animal to Happy Tails?*

What is the color and weight of the animal?*

Was the animal previously adopted from Happy Tails?*
Choose one: Yes No

If not from Happy Tails, where did you get this animal?

How long have you had this dog?*

Has the animal been spayed or neutered?*
Choose one: Yes No

If the animal has not been spayed or neutered, why?*

Has the animal received regular vet exams and vaccinations?*
Choose one: Yes No

Is he/she current on distemper, rabies, bordetella.*

Is the dog current on heartworm preventative?
Choose one: Yes No

Please provide us with the animals vet clinic, vet name and phone number. *

Please describe all known health issues in detail. *

Is there anything else we should know about the cat/dogs health?*

Where does he/she sleep at night?

Is the animal crate trained?
Choose one: Yes No

Do you restrict his/her area in the house. If yes, why.*

On average, how much time does he/she spend alone. Where kept when alone.*

What kind of food are you feeding. How much and when. *

What are his/her favorite treats, toys, exercise.*

Is the animal potty trained.

Does he/she have any accidents. If yes, where and how often.

What are the genders and ages of everyone the animal has lived with?*

What other animals has he/she lived with?*

How is the animal at the vet, groomer, dog park, boarding?*

How is the animal with kids under 5, kids over 5, cats, dogs.*

Has the animal had any formal obedience training. If yes when and where.

What tricks and/or commands does the animal know?

What type of collar is used when the dog is on a leash?

Please describe their barking behaviors.

How does he/she behave when tied outside, loose outside, in a fenced area. loose in the house? On a leash? in a car?

What, if anything will he/she destroy when left alone?*

What are his/her worst habits?*

What, if anything, is he/she afraid of?*

If he/she has shown any aggressive behaviors please describe in detail.

What, if anything, is he/she overly protective of (food, bones, toys etc)?

Has the animal bitten before? If yes, please provide details.

What else do you want Happy Tails to know about the animal you wish to surrender?*