COASTAL K9 OWNER RELINQUISH

Dog's Name

Dog's Gender

Is the dog spayed/neutered?

Is the dog up to date with shots? Please include dates of last shots given.
Rabies, DHPP (distemper/parvo), Bordetella. *

Dates of last shots given

Do you have vaccine records?

Attach Records File

Attach Records File

Pure shepherd or mix? If mix, what breeds?

Please attach pictures of the dog.

How long have you had the dog?

Where did you get the dog?

Why are you rehoming your dog?

Have you tried to resolve the issues? If so, how?

Any medical issues?

Inside or outside dog? Or both?

Where does the dog sleep at night?

Good with LARGE dogs? Males and females?

Good with SMALL dogs? Males and females?

Good with cats?

Good with MEN and WOMEN?

Good with kids and babies?

Housebroken?

Obedience trained?

Protection Trained?

Ever bitten a human? (if yes, please give details)

Ever bitten another dog? If yes, please give details - include SIZE and GENDER of the other dog)

Walk well on leash?

Are you able to keep your dog until we find him/her another home?

Does the dog: BARK a lot? CHEW on things? JUMP fences? (if so, how high is fencing?) Please answer all the questions.

Anything else we need to know about your dog?

Submission of an application is not a guarantee that the dog will be accepted into our Rescue. In some cases, we may already have someone looking for a dog that would be a perfect match. We do our best to help as many dogs as we can, but we receive an overwhelming amount of pleas from owners asking us to take their dogs into our Rescue. *