Owner Surrnder
First Name
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Last Name
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Phone Number
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Dogs Name
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Dogs age
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Dog's sex
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No
Yes
Is the dog fixed?
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Dog's weight
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Dog's breed
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What color is the dog
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Last Vet visit
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What is the name of the last Vet seen
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Vet's Address
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Vet's Phone Number
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Is the Dog Microchipped?
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Is the Dog current on vaccines?
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Heart worm tested in last year?
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Received heartworm preventiative this year? *NOT flea prevention*
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When was the last flea treatment given and what brand or type (Oral, topical, bath, flea collar)
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Has dog ever had puppies?
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Any current medical problems?
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Brand of current dog food?
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How much food and how often?
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Where did you get the dog?
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How long have you had the dog?
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How many owners has this dog had?
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Is the dog house broken?
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Can the Dog jump fence?
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Is the Dog crate trained?
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Is the Dog a digger?
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Is the Dog a barker?
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Is the Dog leash trained?
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Is the Dog obedience trained?
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Is the Dog aggressive with any other Dogs?
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Has the Dog ever shown any aggression to any person or dog?
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Please describe how your Dog interacts with other dogs.
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Is your dog good with other dogs?
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Does the Dog know any commands?
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Is the other Dogs in your home?
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Is there any cats in your home?
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Do you have any kids in your home? if so what ages?
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Where does the Dog go when you are not home?
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How many hours on average does the Dog stay home alone?
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Where does the Dog sleep at night?
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What type of home and yard do you have? If you have a yard, is it fully fenced?
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Is the Dog inside or outside?
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Is your Dog destructive when left alone?
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Is your Dog afraid of anything?
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is the Dog good with cats?
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Is the dog good with kids? If so, what ages?
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Is the Dog good with other dogs?
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Please provide additional information we should know about your Dog?
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Email 4 clear photos and any vet records to milasmutts@gmail.com
Please list your full address for the owner surrender contract
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