Petstablished | Manage your Animal Welfare Organization (AWO) with our easy-to-use software.

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Dog's Information

Basic information about your dog

Dogs Name

Please include names listed on medical records

Breed of Dog

Doberman Pinscher German Shepherd DogDoberman MixGerman Shepherd Mix

Gender of Dog

Male, IntactMale, NeuteredFemale, IntactFemale, Spayed

Age of Dog

Why are you surrendering your dog?

Where did you get your dog from?

If stray, please provide crossroads, city, and state if possible

How long has this dog been in your custody?

When do you need your dog to be placed?

Please allow a minimum of 2 weeks to find placement.

Medical Information

establish any medical history

Are they current on vaccines?

Parvo, Distemper, Rabies, Bordetella, etc.

Yes, current on all vaccinesSome, current on a few but not allNo, past due on everythingUnknown

Have they been tested for Heartworms in the past 6 months?

Yes, tested NegativeYes, tested PositiveNo, hasn't been tested

Is the dog on heartworm prevention?

YesNo

If yes, what type of heartworm prevention are they on?

Dogs Personality and Needs

This section helps us get to know your dog a little bit better in order to place in a compatible foster home.

Tell us a little about your dog's personality

Are they house trained?

YesNoWorking on it

Are they crate trained?

Yes, enjoys the crateNo, haven't tried itNo, has crate anxietyCan be left out without incident

What commands does your dog know?

SitDownCome when calledStayOffLeave ItOthers

Where does this dog stay?

Check all that apply

InsideOutsideIn a runIn a kennelIn a fenced yardIn an Unfenced yardBedroomKennelLoose in house

What is your dogs reaction when meeting new dogs?

Choose all that apply

PlayfulSubmissiveDominantFearfulAvoidsGrowls/Shows teethOtherNot been around other dogs

What does your dog interact well with?

Choose all that apply

Large DogsSmall DogsMale DogsFemale DogsCatsFowl/PoultryGoats/SheepHorsesCowsSmall animals (rabbits, turtles, etc.)

What does your dog NOT get along with?

Check all that apply

Large DogsSmall DogsMale DogsCatsFowl/PoultryGoats/SheepHorsesCowsSmall animals (rabbits, turtles, etc)

What age groups does your dog LIKE?

Check all that apply

Newborn - 1 Year1 Year - 5 Years5 Years - 8 Years8 Years - 13 Years13 Years +Unknown

What age group does your dog NOT like?

Check all that apply

Newborn - 1 Year1 Year - 5 Years5 Years - 8 Years8 Years - 13 Years13 Years +Unknown

Has your dog ever shown aggression towards...

Check all that apply

AdultsChildrenInfantsLarge DogsSmall DogsCatsSmall AnimalsLivestockMen/BoysWomen/GirlsOtherNone of the Above

Have they ever bitten a child or adult?

YesNo

If yes, please describe in detail

Have they ever attacked a dog/cat where there was serious injury or death?

YesNo

Does your dog experience anxiety for any of these reasons?

Check all that apply

WeatherSeperationLoud NoisesCar RidesNew People/AnimalsVets OfficeOtherNone

If yes, please describe in detail

Please list other notable behaviors we need to be aware of.

Please tell us your favorite qualities about your dog

What age groups has your dog been exposed to?

Check all that apply

Newborn - 1 Year1 Year - 5 Years5 Years - 8 Years8 Years - 13 Years13 Years +None

Additional

Please provide a face picture of your dog

Please provide a body picture of your dog

If you have proof of medical history, please add here

I have read and agree to the terms and conditions. By checking this box I am confirming that I am 13 years of age or older.

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Relinquish Request Form

Personal Information

Dog's Information

Medical Information

Dogs Personality and Needs

Additional