SURRENDER FORM

We are a sighthound rescue but we have a small selection of small dog carers available. Please specify breed in the form.

Please fill out this initial questionnaire, more questions will be asked during the telephone conversation.

Reason for Surrender

First Name

Last Name

Phone

Address

What breed is your dog?

How old is your dog?

Is your dog:

Desexed

Up to date with C3 C5 vaccinations (Can you provide vet certificates)

Up to date with Flea and Tick treatment

Wormed and heartwormed

On any medication, name it here?

Please mention an medical issues, we need to know this before surrender.

Is your dog:

Leash reactive

Friendly to other dogs

Good with Kids

Not good with Kids

Separation anxiety

Walks well on the leash

Pulls on the leash, needs training

Is toilet trained

Is NOT toilet trained

Needs medication

Barks lots

Chews furniture

Thanks for submitting, one of our volunteers will call you shortly!

Hounds in Homes acknowledges we are living and working on Aboriginal land. We would like to acknowledge the traditional owners and custodians of country throughout Australia, and their ongoing connection to land, sea and community. We pay our respects to their culture and to Aboriginal Elders, past and present. Sovereignty was never ceded. This always was and always will be Aboriginal land.

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