Great Lakes Boxer Rescue Owner Surrender

Surrender Reason: Please be specific.

Where is the dog at this time? (i.e.; with you, with a family member, etc).
Is this dog currently safe? Is there any reason that their safety could be compromised? Please explain including the date/time when you feel this dog's life, well-being and safety could be compromised:

Name, please include nicknames:

Dog Birthdate/Age:

Sex:

Is the dog spayed or neutered? If not spayed please list the date of last known heat cycle:

How long have you had the dog:

Was the dog adopted from a shelter or rescue? If yes, please tell us which organization, the date
and the ID the animal was given:

If the dog was found as a stray please list the date found and crossroad and nearest town where it
was found. Please write N/A if this does not apply.

Is the dog microchipped? Please provide microchip number.

Was the animal taken to be scanned for a microchip? Please list where the dog was taken to scan for
a microchip and what the findings were. Please write N/A if this does not apply.

Is the dog potty trained/house broken? Explain how they alert when they need to go outside. Any issues going out to potty in rain or snow:

Is the dog crate trained? Please explain crating routine and if not crated, what works best for the dog if they are not crated when left alone. For how many hours can the dog be left alone:

Is the dog good with dogs:

Is the dog good with cats:

Is the dog good with children? Please list the ages of children that the dog has been around:

Has the dog ever bitten a person or other animal? Were the authorities notified? Provide details and
extent of bite (grabbed, hole in shirt, scratch, broke skin, stitches needed):

If surrendering due to any kind of aggression please explain in detail including known triggers. Does the dog guard food, toys, furniture, people etc

If surrendering due to aggression, how is the dog currently being kept separate/safe:

Vet's information: Name, address, phone:

Do you have vet records for the dog? If so, you may scan and upload their history now. If you do not have them available please contact your veterinarian and release them to Great Lakes Boxer Rescue.
Records will need to be emailed to greatlakesboxerrescue@gmail.com:

Is the dog on any current medications and or supplements? If so, please list:

Has the dog been tested for heartworms? If so, list the date of the most recent test:

Please list any medical concerns you have for the dog (example dental disease, lumps and bumps, worms, fleas, failure to thrive, excessive water drinking, excessive licking, constant itching, chronic ear infections, frequent upset stomach, incontinence, excessive weight gain: etc)

Is the dog comfortable with a veterinarian? Have they ever needed to be muzzled for the
veterinarian to examine or do procedures like clean ears, clip nails, blood draws etc:

List the kind of food the dog eats:

Does the dog have any aversion to certain types of food (flavors). Known food allergies:

How is the dog fed? ex. Free food or twice a day? What times? Separate or together. Raised feeder
or not. Type of bowl is the dog used to. ex plastic, metal, ceramic, bucket:

What treats have worked best to motivate the dog? Please list their absolute favorites and what will they NOT eat:

Does the dog require a fence? Please explain and let us know what type of fence they are used to (electric, invisible, physical):

Is the dog a runner and or capable of or a proven fence jumper/climber:

How is your dog riding in a car? Please describe in detail if he/she needs a crate, gets car sickness:

Does the dog have any known fears? If so, please explain and list what is used to calm the dog:

How does the dog act if someone comes to the house:

Where does the dog sleep at night? (In bed with human, in her own human bed, in a dog bed, in
another room or downstairs separated):

What toy is the dog's favorite to your knowledge:

How does the dog do with baths, nail trims, ear cleaning? What has worked best for them? (shower,
bath tub, dog wash, nail clippers, nail grinder etc):

Tell us anything else about the dog. Any traits, any other information we should know:

To move forward with the rehoming process we will need you to provide at least 2 recent pictures of the dog that is needing to be surrendered. (it is preferred that they are taken outside with no
people in the picture). You may upload here or you may text to 517-673-1663 as well as emailing to greatlakesboxerrescue@gmail.org

Additional Photo:

Depending on the location of the foster home (generally towards Michigan) are you willing to help
transport the dog to one of our volunteers? What distance are you comfortable driving?

Do you understand that Great Lakes Boxer Rescue is a foster home based organization. In order for us to help each dog, we must have a foster family that matches up with their needs. This could mean that for dogs needing to be an only dog, it could take time to find a foster family. If GLBR is not able to secure a foster in a timely manner, do you agree to allow us to share this surrender form with other boxer rescues that we partner with? It is not a promise of being able to help, simply opening up more options.

PLEASE READ CAREFULLY:
Please sign by typing your name AND date here: I certify that I am the owner of the described dog, and I release my ownership rights to Great Lakes Boxer Rescue (GLBR). I understand that I am surrendering this dog to GLBR. I am waiving all rights and ownership to this animal. I also certify that this dog does not possess any dangerous or vicious propensities and that I have not willfully concealed information about this dog that might indicate such propensities. The information I have provided about this dog is true and complete. I understand that Great Lakes Boxer Rescue may not be able to place this dog due to its age, health, physical condition, personality, lack of training, or lack of demand. I hereby FOREVER release, discharge, agree to hold harmless and indemnify Great Lakes Boxer Rescue, its board of directors, officers, volunteers, members, and agents of all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of the above described dog. I authorized GLBR to verify the accuracy of the information I have provided. Sign and date:

Thank you. We will review the information provided to see if we may be able to help. Our rescue is 100% volunteer based and we will be in touch as soon as we can. If this is URGENT please call 1-866-309-2957 and someone will try to be in touch as soon as possible.