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Owner Surrender Form

Make sure you have exercised all options, health, behaviors, etc. If you would like to discuss this decision with a volunteer please email Surrender@RedDirtBoxerRescue.com We may be able to assist you with dealing with the problem at hand as opposed to giving up your boxer.

If you made the final decision regarding giving up your dog, the following steps apply:

By pressing this button you will clear all the answers on the application

Dogs Name:
Age:
Date of birth (if known):
Sex:	Male Female
Color Of Dog:	Fawn Brindle White
Owners Name:
Email Address:
Address:
Home Phone Number:
Cell Phone Number:
Veterinarian(s) Name, Address, Telephone Number:
I would like to find my dog a home by (date):
Reason for Surrender :
Has the dog been:	spayed neutered Not spayed or neutered
Has the dog been bred?	Yes No Do Not Know
Has the dog been Injured?	Yes No
If yes to injured explain:
Does the dog have any known medical conditions including allergies?
Is the dog current on all shots?	Yes No
Where does the dog live?	Urban Suburban Rural Farm
Does the dog live in:
If dog lives inside where does it sleep:
Is the dog aggressive toward people :	Yes No
If yes to aggressive toward people please explain :
Does the dog tolerate:
Small Children:	Yes No Don't Know
Other Dogs:	Yes No Don't Know
Cats:	Yes No Don't Know
Is the dog an only dog or in a multiple dog household?	Only Multiple
List age, sex, type of other dogs /cats in household:	Age / Sex / Species
How many hours is the dog used to being left alone during a typical day?	Occasional brief periods 6 hours or less 6 - 8 hours 8 hours or more
Is the dog housebroken?	Yes No some accidents frequent accidents
Is the dog crate trained?	Yes No
How did you most often exercise dog (select all that apply)		Hold Ctr (Windows) or Cmd (Mac) and click to select multiple answers
Please describe the temperament of the dog:
Does the dog enjoy car rides?	Yes No
Is the dog hand shy?	Yes No
Does the dog spook easily?	Yes No
Please select anything the dog is afraid of (select all that apply)		Hold Ctr (Windows) or Cmd (Mac) and click to select multiple answers
Please select any bad habits or behavioral problems the dog has (select all that apply)		Hold Ctr (Windows) or Cmd (Mac) and click to select multiple answers
This will submit the form (Please Press Only Once)