Create Account or Log In:
Creating an account or logging in via facebook/email will let you save your application, and allow you to access your pets medical records and other important information after you adopt or foster.
Dog's Age or Date of Birth
Is your dog altered?
Is your dog AKC registered?
If so, can you provide original copies of their registration?
Is your dog microchipped?
If yes, please provide microchip registry company and number
Reason for Surrender
Where did you originally get your dog?
If other was checked please list here:
Did you sign a return contract with the breeder?
If yes, what is the name and contact information of the breeder?
How long have you owned the dog?
How would you describe your dog?
If other, please explain.
Is your dog housetrained?
If yes but does have bladder control issues, please explain circumstances.
How many hours a day is your dog left alone?
Where is the dog kept when left alone?
If other, please describe where kept alone.
If your dog is crate trained even if they are no longer kept in a crate?
Where is the crate located in the home?
Is the dog destructive when left alone?
If yes, please describe what they destroy or how they react.
What brand of food is your dog fed? (if homemade raw or fresh only please indicate as brand)
How much food at each feeding (cup wise) and how many times a day?
Can you take their food bowl away while eating?
What type of chew items does your dog get?
Can you take the chew item from your dog's mouth without incident?
Does your dog have any favorite toy-please indicate it.
If your dog protective of any toys/space/treat or people-the dog claims as its own?
Has your dog ever bitten a person?
If yes, please describe the circumstances.
Has your dog ever bitten another animal?
If yes, please explain in detail.
When allowed outside, your dog is:
What type of training has your dog had?
If training for behavior issues, what was the issue or concern?
Is your dog good with other dogs?
Has your dog ever been to a dog park to play or exercise?
Does your dog have experience with cats?
How does your dog react to visitors entering your home?
Does your dog have experience with children?
Which of the following describes your dog's personality:
Which describes your household the best?
What type of daily exercise does your dog receive?
How does your dog react to riding in the car?
Is your dog a digger?
Will your dog jump a fence?
How does your dog react when fearful or unhappy?
What have you liked most about this dog?
What have you disliked most about this dog?
Which of the following commands does your dog obey?
Does your dog react in a negative way to the following:
Please explain what your dog does when these above negative events occur or scared or frightened.
Would you surrender all prior vet records for this dog to WGSPR?
Please list this dog's regular veterinarian (include phone number and/or email)
Date of last Rabies vaccine.
Date of last Distemper combo vaccine.
Date of last Heartworm or 4DX test.
What brand of heartworm preventative is this dog taking?
Is this dog on any other type of daily medication?
I will email any medical records for this dog to the rescue I have or provide vet information and give permission so we may obtain records for this dog. Please initial for approval.
I attest that the information I have provided is complete and accurate to the best of my knowledge.
Surrender's name and date
Surrender's name and date (spouse/co-owner)