DOG INFORMATION SHEET
This sheet is designed to help place your dog. PLEASE be honest. Your answers will help us place the dog with people who understand its shortcomings and achievements and help to avoid the dog being returned.
- Today's Date:______9/10/2011_______
- Select one:
a) I can keep this dog until another foster or adoptive home is found, which I understand in some cases could take several months.
b) The very last day I am able to keep this pet is _________________________________
- Dog's name: ________Micah____________________Is this a dachshund mix?: ______________No__________________
Age (DOB, if known): _6 YO____________Weight: __12lbs_____ Color: ______Brown_________ Sex: M
- Your Name: ____Danielle Ferguson___________________________________________________________
Street Address: _______1054 Roy Sellers Rd________________________________________________________
City/State/Zip: ________Columbia, TN, 38401________________________________________________________
- How long has the dog been with you? ___1 year __________________________________________
- Where did you get the dog? __associate___________________________________________________
- If acquired as a stray, have you run a "found" ad with your local paper? YES____ NO____
If yes, what day did the ad start running? __________________________________________
- Is the dog housebroken? YES ___ NO ___ Crate trained? YES ___ NO___
Does the dog have accidents? YES _________ NO ___________________________________
IF YES, when? ________________________________________________________________
- Does the dog chew furniture or other household objects? YES ______ NO _________________
- Does the dog dig holes in the yard? YES _________ NO _______________________________
- Can the dog be left alone inside (without incident?) YES _______ NO ____________________
- Is the dog ever kept outside? YES _________ NO ____________________________________
How many hours a day? _4-7 depending on the weather_______________________________________________________
How is the dog confined to the yard? __fence_____________________________________________
- Where does the dog sleep? __on a dog bed or in the bed with me_____________________________________________________
- Does the dog enjoy riding in a car? __yes_______________________________________________
- Does the dog jump/climb/dig under fences? YES_________ NO_________________________
- What is the dog afraid of (e.g. thunder, vacuum cleaner, etc) __nothing__________________________
- Is the dog good with children? YES _______ NO _________ Don't Know ________________
-
Younger children (under 5 yrs.)? YES ________ NO ________ Don't Know ______________
Do you have children? YES _________ NO ________________________________________
- Is the dog good with cats? YES _________ NO _______ Don't Know ___________________
- Is the dog good with male dogs? YES _______ NO ______ Don't Know __________________
Female dogs? YES _________ NO _______ Don't Know _____________________________
- Has the dog ever bitten anyone? YES___ NO___ IF YES, what were the circumstances: ____________________________________________________________________________
- Does the dog bark when someone comes to the door? YES ________ NO __________________
- Does the dog appear to know any obedience commands or tricks (i.e. sit, stay, fetch, etc.)?
YES___ NO___ IF YES, what? _________________________________________________
- Have you had the dog to the veterinarian? YES___ NO___ IF YES, please provide veterinarian's name & phone number: _Maury County Vet (931)388-4750___________________________________________________________
- What veterinary (or other) care was provided?
Vaccinations? YES____ NO____ Date: ____________________________________________
Rabies? YES____ NO____ Date: _Summer 2011___________________________________________
Heartworm Test? YES____ NO___ Date: ____________________________________________
Heartworm Prevention? YES___ NO___ Date & Product given: ________________________
Flea Treatment? YES____ NO____ Date & Product given: _August 13, 2011 BioGuard___________________________
Does the dog appear to have any health problems? YES___ NO___ IF YES, please explain:
His nails were not kept clipped by his former owners. We are still working on getting them down to a comfortable length. The vet said to clip them every 3 weeks or so. ______________________________________________________________________________
- Has the dog been spayed / neutered? YES ____NO ____ IF YES, when?__Unknown_______________
- Describe this dog's personality (select all that apply): ___high energy; ___laid back; ___calms easily; ___excites easily; ___jumps on people; ___walks well on leash; ___pulls on leash; ___lap dog; ___people-oriented
- What do you feed him/her? __Purina brand food only____________________________________________________
How often? __Once a day________________________________________________________________
- Does the dog have a collar? YES______ NO________________________________________
Will the dog come with any other items (i.e. food, doghouse, bed, etc.)? YES______ NO_____
If so, what? ____________________________________________________________________
- I plan to make a donation in the amount of $__20.00_________ to help offset veterinary expenses that will be incurred for the dog.
-
- Check one (for spayed/neutered pets only): ___I want to be the point of contact for potential adopters; or ___I want to be the point of contact for potential adopters. Please include the following phone #s/email on your website: _doozer1345@yahoo.com___________________________________________
- Check one: ___I will email several pictures of this dog; ___Please help me get pictures of this dog.
- Additional Comments: He is a very sweet loving dog. I have 5 dogs who are much younger and large breeds, so it is very hard to meet his needs with him being small and more mature. __________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
0 comments:
Post a Comment