First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone

How did you hear about us?*

Animal(s) Names(s):*

Breed:*

Age/Sex:*

Is pet spayed or neutered?*
Choose one: Yes No

Color/weight:*

What is coat length? (short/medium/long)*

Why is dog being surrendered:*

Please list the name and phone number for the veterinarian/veterinary clinic that has provided medical care to your pets (current and past) below. (Out of area vets are acceptable.) ****If the records are under a different dog(s) name or client name, please let us know, so your application doesn't get delayed in processing*****

What, if any, vaccines has he/she had, and when are they due?*

Medical history: Overall health:*

Chronic medical problems:*

List any medications or special foods the dog is currently on*

Has the dog ever bitten, snapped, or shown any signs of aggressive behavior with people, kids, other animals?*

Housetrained (Y/N)*
Choose one: Yes No

Describe the dog's energy level (high, medium, low)*

Good with children/toddlers?*

Is pet good with males only, females only, or both?*

Good with other dogs/cats?*

Jumper, digger or chewer?*

Beg for food or countersurf?*

Had any obedience training?*
Choose one: Yes No

Fence jumper/jump on people?*

Is pet suitable for a home without a fenced yard?*
Choose one: Yes No I don't know

Crate trained/uses crate now?*

Is pet suitable for an apartment?*
Choose one: Yes No I don't know

How much freedom in the house?*

Walks well on leash?/trusted off leash?*

Rides well in the car?*
Choose one: Yes No I don't know

Does the dog have any temperament issues? (separation anxiety, fear of thunderstorms, etc.)*

Any grooming issues? Feet? Ears?*

What play activities does your dog enjoy? Swimming?*

Where is dog currently kept? (inside/outside/basement, etc.)*

Is there any additional information we should know?*

*****We are a foster rescue organization. Our foster homes are often filled to capacity. Are you able to foster the dog(s) until we have a foster home available, or until we can get it adopted? We cover all costs, you just have to bring them to our adoption events on Saturdays and provide a loving home.*
Choose one: Yes No

***IT'S A REQUIREMENT THAT YOU EMAIL PHOTOS OF THE DOG TO PETPALS@CABARRUSPETS.COM. WE MUST GET THEM BEFORE WE CAN PROCEED WITH TRYING TO HELP PLACE YOUR DOG INTO A FOSTER HOME. ONCE WE RECEIVE THEM, WE WILL CONTACT YOU BY EMAIL TO DISCUSS YOUR OPTIONS.