Owner Surrender - Dog - Pet Haven of Minnesota

Date*
MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Dog's Name*
Did you adopt your dog from Pet Haven?*
- Yes
- No
If you adopted from Pet Haven, when did the adoption take place?
Where did you get your dog?*
How long have you owned your dog?*
What breed is your dog?*
How much does your dog weigh?*
What age is your dog?*
What is your dog's gender?*
- Male
- Female
Why are you surrendering?*
Please briefly explain why you are looking to surrender your dog.
How long are you able to continue to house your dog?*
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.
Traits & Habits
Are there any wonderful, special traits or habits that you would like his/her new family to know about?
Does your dog have accidents in the house?*
- Yes
- No
How often do the accidents happen?
How long can your dog "hold it"?*
Time Alone*
How long is your dog left alone without people most days?
Is your dog crate trained?*
- Yes
- No
Time in Crate*
How much time does your dog spend in the crate each day?
Location Alone*
When left alone where is your dog located?
- Outdoors
- Free at home
- Confined to a room
- Crated
Behavior Alone*
When alone does your dog do any of the following? Please check all that apply.
- Damage household items
- Urinate
- Defecate
- Bark Frequently
- Cry Frequently
- None of the above
Household Item(s) Damage
When your dog is alone and damages household items, please check all behaviors that apply.
- Chews windows or doors
- Chews furniture
- Chews clothing or shoes
- Chews toys
- Other
- None
Handling*
How does your dog react to handling such as petting, hugging or bathing?
Does your dog get along with other dogs?*
Please describe your dog's play style/energy level.
Does your dog get along with cats?*
Does your dog like children?*
Touch Response
If touched in any of the above places how does your dog respond?
- Moves away
- Shows teeth
- Growls
- Snaps
- Bites
- No reaction
- Doesn't react negatively when touched anywhere
- Other
Touch Sensitivity
Are there areas on the dog’s body your dog does NOT like to be touched? Please check all that apply.
- Ears
- Mouth
- Tail
- Collar
- Rear End
- Paws/Nails
- No Issues
- Other
Has your dog ever bitten a person?
- Yes
- No
Bite Details
If your dog has bitten a person, please describe the bite(s).
Car Behavior
How does your dog behave in the car? Please check all that apply.
- Enjoys
- Afraid
- Resists Entering
- Sleeps
- Barks
- Vomits
- Urinates
- Defecates
- Never Tried
- Fine in a Crate
Behavior when Eating
How does your dog react when you or another family member pet him/her or touch the bowl or food while he/she is eating? Please check all that apply.
- No reaction
- Never tried
- Allows
- Lunges
- Shows teeth
- Growls
- Snaps
- Bites
Behavior with Toy in Mouth
How does your dog react when you or another family member pets him/her or touches a toy while it's in the dog's mouth?
- No reaction
- Never tried
- Allows
- Lunges
- Shows teeth
- Growls
- Snaps
- Bites
Behavior when on Furniture
How does your dog react when you or another family member pushes or pulls him/her off of furniture?
- No reaction
- Never tried
- Allows
- Lunges
- Shows teeth
- Growls
- Snaps
- Bites
Training
Has your dog completed any training? If so, please describe.
Commands
What commands does your dog understand?
- Sit
- Stay
- Leave it
- Come
- Down
What are the dog’s favorite kinds of toys?
Behavior while Sleeping
How does your dog react when you or another family member pets him/her or moves him/her while sleeping?
- No reaction
- Never tried
- Allows
- Lunges
- Shows teeth
- Growls
- Snaps
- Bites
Medical History
Has your dog been spayed or neutered?
- Yes
- No
- I don't know
Has your dog ever had surgery?
- Yes
- No
- I don't know
Surgery Details
Please explain.
Vet Behavior
How does your dog behave during visits to the vet?
Has your dog been tested for Heartworm?
- Yes (tested negative)
- Yes (tested positive)
- I don't know
Vet Info
Please provide your veterinarian's name and phone number (Pet Haven will require records prior to placement).
Additional Info
Is there anything you want a new family to know about your dog’s interaction with men, women, children, other dogs, cats, other animals or people?
Photos
Including photos of your pet increase the likelihood of finding foster placement and speed up the fostering process. Please attach 1-2 photos of your pet (upload file size limit: 50 MB)
Drop files here or

Max. file size: 50 MB.
Vet Records
Including your pet's vet records increases the likelihood of Pet Haven finding a foster for your dog and speeds up the placement process. Please attach your dog's vet records.
Drop files here or

Max. file size: 50 MB.
You should receive a response from us within 24-48 hours. If you have not received an email, please check your spam folder.
Other Options
Are you interested in discussing options other than surrender with a Pet Haven representative (such as training techniques or behavior assistance)?
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.

Owner Surrender – Dog

Dog Owner Surrender/Return

Medical History