CDR Rehoming Application

Cayuga Dog Rescue Rehoming Application

Where did you hear about us?
Dog's Name:
Your Full Name (first and last):
Your Spouse's/Partner's Full Name (first and last):
Street Address: NO PO Boxes Please!
City: State:	Zip Code:
Your Home Telephone Number:
Your Alternate Telephone Number:
YOUR e-Mail address:
Are you 21 years of age or older?	Yes No
What is the Breed / Mix of your dog?
What is the age of your dog?	What is the sex of your dog?
Is your dog Spayed or Neutered? (We will require a copy of the certificate.)	Yes No
Is your dog up to date on all of his/her shots? (We will require copies of all veterinary visits including vaccination records.)	Yes No
Please briefly describe the reason(s) why you are giving up your dog.
Who is your current veterinarian?
Current Vet's Street Address:
City: State:	Zip Code:
Current Vet's phone number:
Your dog is used to: (Please check ALL that apply)	Fenced Yard Outside Cable Run	Running Free Leashed Walks
Your Dog is: (Please check ALL that apply)	Mostly Housebroken 100% Housebroken Crate Trained	Good with Kids Good with Other Dogs Good with Cats
When you are in the house, where is the dog allowed to be?
When no one is in the house, where do you leave the dog?
Does your dog have any current medical problems? (Please describe and note if treatment has been attempted.)
Has your dog had any previous medical problems? (Please describe and note what treatment was used.)
Does your dog have any current behavioral/emotional problems? (Please note what has been tried in an attempt to address the problem.)
Has your dog had any past behavioral or emotional problems? (Was the issue resolved and how?)
Has your dog ever bitten another dog? (If YES, please describe the situation and / or circumstances in detail.)
Has your dog ever bitten a HUMAN? (If YES, please describe the situation and circumstances in detail.)
Is your dog an "Escape Artist"? (Meaning will your dog run out the door or run off if given the chance?)	Yes No
Does your dog have any obedience training? (If YES, please describe)
Where does your dog sleep?
Please describe your dog's personality, habits and detail any endearing qualities. We will post this information in your dog's description on our website to assist in attracting attention to your dog.
By submitting the Rehoming Application, I am certifying that: ◊ I am at least 21 years of age. ◊ I am the legal owner and the responsible person for the care and well-being of this dog. ◊ In submitting this Rehoming Application, I give Cayuga Dog Rescue representatives permission to contact my veterinarian for information to assist CDR in determining whether or not to accept a dog from me. The above application MUST be fully completed to be accepted!