(MUST be WHITE or mostly WHITE/CREAM)
Is your dog current on all vaccinations?:
Yes No Unanswered
HAS YOUR DOG BEEN VACCINATED FOR RABIES WITHIN THE LAST 3 YEARS?:
Yes No Unanswered
Expiration of rabies: (This information MUST be provided. If your dog does not have a current rabies vaccination, we will ask you to obtain one.)
Do both of your dog's ears stand up?:
Yes No Unanswered
Is your dog on Heartworm preventative?: Yes No Unanswered
When was your dog last tested for Heartworm?:
Does your dog have a microchip or tattoo?:
Yes No Unanswered
Brand of Microchip (Avid, Home Again, etc.) and number of chip:
Do you have AKC or SV papers on your dog?:
Yes No Unanswered
Where did you get your dog from?:
Breeder
Shelter
Rescue Group
Found as a Stray
Classified Ad
Friend, Relative or Neighbor
Unanswered
If from a breeder, the breeder's name and/or kennel name:
If from a rescue group, which one, in what state and did you sign a contract?:
EXACTLY how long have you had this dog?:
EXACTLY where do you keep the dog when you are not home? (Please be specific, i.e., loose outside, outside in a kennel, indoors free, indoors in a crate, in the laundry room, etc.:
Is this an indoor or an outside dog?:
Indoors Outside Unanswered
EXACTLY where does your dog sleep at night?:
Is your dog reliably housebroken?:
Yes No Unanswered
Is your dog crate trained?:
Yes No Unanswered
Is your dog destructive?:
Yes No Unanswered
Has your dog ever been left loose in the house while no one was home?:
Yes No Unanswered
Does your dog panic when left alone (i.e., barking, pawing at blinds or under doorways, scratching on doors, escaping, vocalizing, eliminating and otherwise manifesting separation anxiety?:
Yes
If YES, please describe:
Has your dog had ANY formal (obedience) training/classes?:
Yes No Unanswered
If yes, where, when and with whom?:
Is your dog well socialized (i.e., FREQUENTLY taken OFF its home property and exposed to strangers, strange dogs, strange things and public places?:
Yes No Unanswered
Is your dog frequently exposed to other strange dogs as in on the street in the park, or walking?:
Yes No
If yes, HOW OFTEN?
How does your dog respond to unfamiliar dogs?
lunges & barks
retreats or tucks tail
drops down into play posture
raises hackles (hair on neck) and just barks
I don't know, dog rarely gets to see other dogs
How often do you walk your dog? (If not at all, please indicate "NEVER"):
If yes, do you usually walk to the same place most, if not all, of the time?:
Yes No Unanswered
Does your dog walk well on a leash or does he/she pull?:
Yes No, pulls Unanswered
How well does dog ride in a vehicle?
Very well Gets carsick Paces or vocalizes Jumps in the front seat
Unanswered
If no, please explain (i.e., gets car sick, jumps in the front seat, etc.):
Has or does your dog live with children or toddlers? If so, indicate their ages:
How well does your dog interact with children and toddlers?:
How well does your dog interact with small or toy breed dogs?:
Has your dog lived with cats?: Please elaborate
What other pets do you have and how does your dog get along with them? (ferrets, livestock, reptiles, etc.)?:
If you had to use TWO of the following words ONLY, how would you describe your dog? Please keep in mind that this is a high energy breed which is not the same as hyperactive. And submissive & confident seldom go hand-in-hand.
Submissive
Dominant
Aggressive
Fearful
Confident
Skittish/Shy
Nervous/Neurotic
Overly Protective
Passive
Hyperactive
Does your dog bolt or escape often?:
Yes No Unanswered
If yes, please explain:
Does your dog have any health issues, including allergies?:
Yes No Unanswered
If yes, please elaborate:
What, if any, medication is your dog on? (If none, please indicate "NONE"):
Was your dog ever tested for Valley Fever?:
Yes No Unanswered
Was your dog ever diagnosed with or treated for Valley Fever?:
Yes No Unanswered
If yes, please elaborate:
Does your dog have hip dysplasia or arthritis?:
Yes No Unanswered
Have your dog's hips ever been x-rayed??:
Yes No Unanswered
If so, at what age?:
Does your dog have any behavioral issues?:
Yes No Unanswered
If yes, please elaborate:
Has your dog ever bitten anyone?:
Yes No Unanswered
How does your dog typically respond to strangers? (please check all that apply):
Submissive
retreats / fearful
lunges & barks
outgoing and friendly
O.K. if not touched
Growls/aggressive
readily accepts petting
my dog is never exposed to strangers
Has your dog ever attacked another dog?:
Yes No Unanswered
Does your dog know how to swim?:
Yes No Unknown Unanswered
Does your dog show a preference for either men or women?:
Yes, Men Yes, Women No Unanswered
Why are you surrendering your German Shepherd Dog?
Are you able to continue to house and care for this dog while we work to place him/her?:
Yes No Unanswered
PLEASE NOTE: WE HAVE DOGS ON A WAIT LIST FOR FOSTER SPACE.
In the event you need IMMEDIATE placement for your dog and/or are unable to continue to provide housing for any length of time, it is unlikely that we will be able to help. After evaluating your dog we must find a suitable foster home which takes time, particularly if your dog has behavioral issues.
Most rescue organizations are full, as are the local shelters. Currently there is a shortage of foster homes. If, however, you are able to provide temporary housing for your dog, we CAN move forward.
**IMPORTANT WARNING!!**
Please click and read above link if you are short
on time to re-home your dog
If you cannot continue to house your dog, how much longer can you keep your dog while we endeavor to locate a suitable foster home? *YOU MUST ENTER AN ACTUAL TIME FRAME (e.g., "3 weeks, 1 month, as long as it takes")* :
Have you or do you plan to place a classified ad to market your dog?
(Please note: this is potentially very dangerous)
Are you willing to consider training to address issues which could enable you to keep your dog?:
Yes No Unanswered
Are you working with any other agencies or rescue groups?:
Yes No Unanswered
What is the name and location of the veterinary clinic this dog has been to?:
What is the date (month and year) of your dog's last vet visit: and the reason for the visit?
Are you able to bring your dog to us for its evaluation next weekend?:
Yes No Unanswered
If not, when?
If you have access to a digital camera, it would be very helpful if you could Email Nancy at WhiteGSDRescue@aol.com
several photos (taken outdoors during the day) of your dog. We would prefer a face (front) shot, a standing (side) shot and a sitting (front) shot if possible. JPEG attachments are best.
Please allow 6 hours for us to review your dog's information. If you do not receive an email response, then please email Nancy at the email address above.
We will email you within 48 hours upon receipt of this form.
If we do not hear back from you within 10 days your
dog's file will be closed.
We ask you to disclose everything negative or positive about your dog. We are very candid with our potential adopters. We know that anything, whether it be health or behavior related, will come to the surface eventually. We would much rather deal with such issues up front rather than months after a dog has been re-homed, resulting in their return and yet another displacement.
If your dog has a bite history, you (and we) are bound by law to disclose this information. If you don't, you could be liable for a subsequent bite for not having made it known. A bite does not necessarily mean that your dog is not adoptable; many people put German Shepherds in situations they shouldn't and many other factors are taken into consideration...just be honest and forthcoming.