Person providing information *
Owner
Friend
Family
First Name *
Surname *
Address *
Suburb *
Postcode *
Best Contact Number *
Email Address *
Owner's reason for surrendering your dog? *
Dogs Name *
Please choose Dog. *
Dog
What breed is your Dog? *
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Abyssinian
Affenpinscher
Afghan Hound
Airedale Terrier
Akita x
American Bulldog
American Johnson Bulldog
American Staffordshire Bull Terrier
American Wirehair
Anatolian Shepherd
Australian BullDog
Australian Cattle Dog
Australian Mist
Australian Shepherd
Australian Terrier
Balinese Cat
Bandog
Barb (Kelpie)
Basenji
Basset Hound
Beagle
Bearded Collie
Belgian Shepherd
Bengal
Bernese Mountain Dog
Bichon Frise
Birman
Black Mouth Cur
Bloodhound
Blue Cattle
Blue Heeler
Bluetick Coonhound
Bobtail
Bombay
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flanders
Boxer
Boxer X Cattle
British Shorthair
Brittany Spaniel
Brussels Griffon
Bull Arab
Bull Enduro
Bull Mastiff
Bull Terrier
Burmese
Burmilla
Cairn Terrier
Calico
Canaan Dog
Catahoula
Cattle Dog
Cavalier King Charles Spaniel
Chartreux
Chihuahua
Chinchilla
Chinese Crested Dog
Chow Chow
Clumber Spaniel
Cocker Spaniel
Collie
Coonhound
Corgi
Cornish Rex
Cross-Breed
Cymric
Dachshund
Dalmatian
Devon Rex
Dilute Calico
Dilute Tortoiseshell
Doberman Pinscher
Dogue de Bordeaux
Domestic Long Hair
Domestic Medium Hair
Domestic Short Hair
Dutch Shepherd
Elkhound
English Bulldog
English Coonhound
English Pointer
English Setter
English Shepherd
English Springer Spaniel
English Staffy
English Toy Spaniel
English Toy Terrier
Entlebucher
Exotic Shorthair
Field Spaniel
Fila Brasileiro
Finnish Lapphund
Finnish Spitz
Flat-coated Retriever
Foxhound
Fox Terrier
French Bulldog
French Mastiff
German Coolie
German Pinscher
German Shepherd
German Shorthaired Pointer
German Wirehaired Pointer
Glen of Imaal Terrier
Golden Retriever
Gordon Setter
Great Dane
Greater Swiss Mountain Dog
Great Pyrenees
Greyhound
Griffin Bruxellois
Havana
Havanese
Heinz
Himalayan
Hound
Hovawart
Huntaway
Husky
Ibizan Hound
Illyrian Sheepdog
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Italian Spinone
Jack Russell Terrier
Japanese Bobtail
Japanese Chin
Javanese
Jindo
Kai Dog
Karelian Bear Dog
Keeshond
Kelpie
Kelpie
Kelpie X Border Collie
Kelpie X Heinz
Kerry Blue Terrier
Kishu
Komondor
Koolie
Korat
Kuvasz
Kyi Leo
Labrador
Labrador X Border Collie
Lakeland Terrier
Lancashire Heeler
Leonberger
Lhasa Apso
Löwchen
Lurcher
Lynx
Maine Coon
Malamute
Maltese
Manchester Terrier
Manx
Maremma Sheepdog
Mastiff
McNab
Miniature Pinscher
Mini Dachshund
Mini Foxi
Mountain Cur
Mountain Dog
Munchkin
Munsterlander
Neapolitan Mastiff
Newfoundland Dog
New Guinea Singing Dog
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Forest Cat
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck-Tolling Retriever
Ocicat
Old English Sheepdog
Oriental Long Hair
Oriental Short Hair
Oriental Tabby
Otterhound
Papillon
Patterdale Terrier (Fell Terrier)
Pekingese
Persian
Peruvian Inca Orchid
Petit Basset Griffon Vendeen
Pharaoh Hound
Pit Bull Terrier
Pixie-Bob
Plott Hound
Pointer
Polish Lowland Sheepdog
Pomeranian
Poodle
Portugese Podengo
Portuguese Water Dog
Powder Puff
Presa Canario
Pug
Puli
Pumi
Ragamuffin
Ragdoll
Rat Terrier
Redbone Coonhound
Retriever
Rhodesian Ridgeback
Rottweiler
Russian Blue
Saint Bernard St. Bernard
Saluki
Samoyed
Schipperke
Schnauzer
Scottish Deerhound
Scottish Fold
Scottish Terrier Scottie
Sealyham Terrier
Selkirk Rex
Semi Long Hair
Semi Long Hair Domestic
Setter
Shar Pei
Sheep Dog
Shepherd
Shetland Sheepdog Sheltie
Shiba Inu
Shih Tzu
Siamese
Siberian
Siberian Husky
Silky Terrier
Singapura
Skye Terrier
Sloughi
Smithfield Cattle dog
Smooth Fox Terrier
Snowshoe
Somali
South Russian Ovcharka
Spaniel
Sphynx (hairless cat)
Spitz
Spoodle
Staffordshire Bull Terrier
Staghound
Stumpy Cattle
Swedish Vallhund
Swiss Shepherd
Tabby
Tenterfield Terrier
Terrier
Thai Ridgeback
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Tiger
Tonkinese
Torbie
Tortoiseshell
Tosa Inu
Toy Fox Terrier
Toy Poodle
Treeing Walker Coonhound
Turkish Angora
Turkish Van
Tuxedo
Unknown
Unknown
Vizsla
Weimaraner
Welsh Corgi
Welsh Springer Spaniel
Welsh Terrier
West Highland Terrier
Wheaten Terrier
Whippet
White German Shepherd
Wire haired Foxi
Wire haired Jack Russell
Wire-haired Pointing Griffon
Wirehaired Terrier
Wolfhound
Xoloitzcuintle/Mexican Hairless
Yellow Labrador Retriever
Yorkshire Terrier Yorkie
Choose 2nd breed if your dog is a crossbreed.
?
?
Abyssinian
Affenpinscher
Afghan Hound
Airedale Terrier
Akita x
American Bulldog
American Johnson Bulldog
American Staffordshire Bull Terrier
American Wirehair
Anatolian Shepherd
Australian BullDog
Australian Cattle Dog
Australian Mist
Australian Shepherd
Australian Terrier
Balinese Cat
Bandog
Barb (Kelpie)
Basenji
Basset Hound
Beagle
Bearded Collie
Belgian Shepherd
Bengal
Bernese Mountain Dog
Bichon Frise
Birman
Black Mouth Cur
Bloodhound
Blue Cattle
Blue Heeler
Bluetick Coonhound
Bobtail
Bombay
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flanders
Boxer
Boxer X Cattle
British Shorthair
Brittany Spaniel
Brussels Griffon
Bull Arab
Bull Enduro
Bull Mastiff
Bull Terrier
Burmese
Burmilla
Cairn Terrier
Calico
Canaan Dog
Catahoula
Cattle Dog
Cavalier King Charles Spaniel
Chartreux
Chihuahua
Chinchilla
Chinese Crested Dog
Chow Chow
Clumber Spaniel
Cocker Spaniel
Collie
Coonhound
Corgi
Cornish Rex
Cross-Breed
Cymric
Dachshund
Dalmatian
Devon Rex
Dilute Calico
Dilute Tortoiseshell
Doberman Pinscher
Dogue de Bordeaux
Domestic Long Hair
Domestic Medium Hair
Domestic Short Hair
Dutch Shepherd
Elkhound
English Bulldog
English Coonhound
English Pointer
English Setter
English Shepherd
English Springer Spaniel
English Staffy
English Toy Spaniel
English Toy Terrier
Entlebucher
Exotic Shorthair
Field Spaniel
Fila Brasileiro
Finnish Lapphund
Finnish Spitz
Flat-coated Retriever
Foxhound
Fox Terrier
French Bulldog
French Mastiff
German Coolie
German Pinscher
German Shepherd
German Shorthaired Pointer
German Wirehaired Pointer
Glen of Imaal Terrier
Golden Retriever
Gordon Setter
Great Dane
Greater Swiss Mountain Dog
Great Pyrenees
Greyhound
Griffin Bruxellois
Havana
Havanese
Heinz
Himalayan
Hound
Hovawart
Huntaway
Husky
Ibizan Hound
Illyrian Sheepdog
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Italian Spinone
Jack Russell Terrier
Japanese Bobtail
Japanese Chin
Javanese
Jindo
Kai Dog
Karelian Bear Dog
Keeshond
Kelpie
Kelpie
Kelpie X Border Collie
Kelpie X Heinz
Kerry Blue Terrier
Kishu
Komondor
Koolie
Korat
Kuvasz
Kyi Leo
Labrador
Labrador X Border Collie
Lakeland Terrier
Lancashire Heeler
Leonberger
Lhasa Apso
Löwchen
Lurcher
Lynx
Maine Coon
Malamute
Maltese
Manchester Terrier
Manx
Maremma Sheepdog
Mastiff
McNab
Miniature Pinscher
Mini Dachshund
Mini Foxi
Mountain Cur
Mountain Dog
Munchkin
Munsterlander
Neapolitan Mastiff
Newfoundland Dog
New Guinea Singing Dog
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Forest Cat
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck-Tolling Retriever
Ocicat
Old English Sheepdog
Oriental Long Hair
Oriental Short Hair
Oriental Tabby
Otterhound
Papillon
Patterdale Terrier (Fell Terrier)
Pekingese
Persian
Peruvian Inca Orchid
Petit Basset Griffon Vendeen
Pharaoh Hound
Pit Bull Terrier
Pixie-Bob
Plott Hound
Pointer
Polish Lowland Sheepdog
Pomeranian
Poodle
Portugese Podengo
Portuguese Water Dog
Powder Puff
Presa Canario
Pug
Puli
Pumi
Ragamuffin
Ragdoll
Rat Terrier
Redbone Coonhound
Retriever
Rhodesian Ridgeback
Rottweiler
Russian Blue
Saint Bernard St. Bernard
Saluki
Samoyed
Schipperke
Schnauzer
Scottish Deerhound
Scottish Fold
Scottish Terrier Scottie
Sealyham Terrier
Selkirk Rex
Semi Long Hair
Semi Long Hair Domestic
Setter
Shar Pei
Sheep Dog
Shepherd
Shetland Sheepdog Sheltie
Shiba Inu
Shih Tzu
Siamese
Siberian
Siberian Husky
Silky Terrier
Singapura
Skye Terrier
Sloughi
Smithfield Cattle dog
Smooth Fox Terrier
Snowshoe
Somali
South Russian Ovcharka
Spaniel
Sphynx (hairless cat)
Spitz
Spoodle
Staffordshire Bull Terrier
Staghound
Stumpy Cattle
Swedish Vallhund
Swiss Shepherd
Tabby
Tenterfield Terrier
Terrier
Thai Ridgeback
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Tiger
Tonkinese
Torbie
Tortoiseshell
Tosa Inu
Toy Fox Terrier
Toy Poodle
Treeing Walker Coonhound
Turkish Angora
Turkish Van
Tuxedo
Unknown
Unknown
Vizsla
Weimaraner
Welsh Corgi
Welsh Springer Spaniel
Welsh Terrier
West Highland Terrier
Wheaten Terrier
Whippet
White German Shepherd
Wire haired Foxi
Wire haired Jack Russell
Wire-haired Pointing Griffon
Wirehaired Terrier
Wolfhound
Xoloitzcuintle/Mexican Hairless
Yellow Labrador Retriever
Yorkshire Terrier Yorkie
Sex *
Male
Female
How old is your dog? *
Has your dog been Desexed? *
Yes
No
Unsure
Does your dog have a microchip? *
No Yes
Is the microchip name in your name? *
Yes
No
Unsure
Is your dog up to date with it's annual vaccinations? *
No Yes
How long have you owned your dog? *
Where did you get your dog from initially? *
Personality Description of your dog *
Does your dog have any Anxiety, Medical Issues, Dietary requirements, Behavourial, Aggression issues? Please describe... *
Where does your dog sleep? Please describe *
Please describe your dog's feeding regime - brands of food, scraps, dry or tinned, flavours, feeding times and quantities. Any dislikes? *
What is your dog's reaction if you approach it when it is feeding? *
What kind of fencing do you have? *
6ft Timber Brick or Colorbond - my dog does not escape
6ft Colorbond Fence - my dog can climb
6ft Timber Fence - my dog can climb
4ft Fence - my dog does not jump
Fence needs to have concrete at the bottom as they dig
Wire fencing is fine - they don't climb
Any fence is fine
My dog is hard to contain as they like to escape
I don't have a fence
They prefer to be inside
Does your dog have escaping issues, what have you done to remedy? *
Has your dog lived with other dogs? *
No Yes
If so, please specify age and sex and what their interactions are like. *
Has your dog lived with cats? *
No Yes
If yes, is your dog comfortable with them?
Has your dog lived with animals other than cats and dogs? ie livestock, pocket pets *
No Yes
If yes, please specify the species and their reaction to them. *
Has your dog lived with children? *
No Yes
If so, please specify ages *
Is your dog comfortable around children? Please describe their relationship or concerns *
How does your dog react when he/she has done something wrong? How do you "correct them"? *
Does your dog return when called whilst off the lead? *
No Yes
Is your dog toilet trained? Please describe any toileting issues. *
No Yes
What commands does your dog obey? And what commands are used? For example, sit or sit down; lie or lie down etc. *
Would you describe your dog as a gentle player or does he/she like "rough" play? Describe your animal's play activity, eg. favourite game, favourite toy, etc. *
Does your dog pull on the lead? Do you use Collar, Halti, Gentle Leader? *
Do you leave your dog alone for any period of time? If so, how long for and do you have concerns about them being on their own? Where do you leave them? *
Has your dog ever been destructive in the house or yard? Please describe *
Does your dog have storm/fireworks fear? What do you do to ease it? *
Has your pet caused injury to another animal or person? Please describe.. *
Does your dog travel well in cars? *
No Yes
Photo of your Dog
Photo of your Dog
Owner Signature *
Clear