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.
Fill out the form below. Please complete all sections of it.
Is the pet spayed or neutered?
Reason for surrendering the dog/cat (please explain in as much detail as possible)
Where did you get the dog/cat and how long have you had it for? *If you got this animal from a rescue group or shelter please provide name of agency.
Any other pets in your home?
If yes, please explain
Is the dog friendly with any of the following?
How is the dog on a leash?
For how long is the dog left alone during the day and does he or she ever have accidents?
Where is the dog left when alone?
Has the dog ever bitten a human or another dog?
If yes, please explain what happened.
Is the dog possessive over any of the following? Please check all that apply:
Is the dog destructive to any of the following? Please check all that apply:
Is there excessive barking or separation anxiety?
How does the dog act when people come to the house?
Does the dog exhibit any abnormal or quirky behavior?
If yes, please explain.
How would you describe the energy level of the dog?
Please explain any other problems you are having with your dog.
Please provide dates the following vaccines were last administered for the dog:
Name, Address and Phone Number of Veterinarian
Date last seen by Veterinarian and why
Has your pet ever been diagnosed or treated for anything by a veterinarian or take medication on a regular basis?
How did you hear about Rescue Haven Foundation?