Owner Surrender - Dog - Pet Haven of Minnesota

Your Name *

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Address *

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City *

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State *

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Zip *

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Best Phone Number to reach you *

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Email Address *

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Dog's Name *

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Did you adopt your dog from Pet Haven? *

Yes
No

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What breed is your dog? *

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How much does your dog weigh? *

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Dog's Age *

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Dog's Gender *

Female
Male

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Briefly explain why you are looking to surrender your dog. *

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Pet Haven does our best to find fosters for all of the dogs that we can and will always be able to help a dog that was adopted from Pet Haven, but some dogs are more difficult to place and may take days to weeks to find and appropriate and safe foster home for. Some dogs may be easiest fostered by their surrendering owners. Keeping this in mind, how long are you able to continue to house the dog?" *

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Where did you get your dog? *

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How long have you owned your dog? *

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Are there any wonderful, special traits or habits that you would like his/her new family to know about?

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Is your dog housetrained? *

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Does your dog have accidents in the house? *

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If yes, how often?

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How long can your dog "hold it"? *

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Is your dog crate trained? *

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If yes, how long did the dog spend in the crate each day?

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How long is your dog left alone, without people? *

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If your dog destroys household items, does he or she:

Chew windows or doors?
Chew furniture?
Chew clothing or shoes?
Chew toys?
Other

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How does your dog react to bathing / handling such as petting or hugging?

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Does your dog get along with other dogs? *

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Does your dog get along with cats? *

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Does your dog like children? *

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Has your dog ever bitten a person? *

Yes
No

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If your dog has bitten a person, please describe the bite(s).

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Is the dog permitted to sit and/or sleep on furniture?

Yes
No

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Has your dog completed any training? If yes, please describe.

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What are the dog’s favorite kinds of toys?

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Has your dog ever had surgery?

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If yes, please explain:

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How does your dog behave during visits to the vet?

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Is your dog spayed or neutered? *

Yes
No

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Has your dog been tested for Heartworm? *

Yes- my dog tested negative
Yes- my dog tested positive
I don't know

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Please provide your veterinarian's name and phone number (Pet Haven will require records prior to placement)

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Is there anything you want a new family to know about your dog’s interaction with men, women, children, other dogs, cats, or other animals or people?

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Are you interested in discussing options other than surrender with a Pet Haven representative (such as training techniques or behavior assistance?)

Yes
No

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Owner Surrender – Dog

Owner Surrender – Dog

Household History

How does your dog react when you or another family member...

Medical History