White German Shepherd Rescue

PLEASE READ SURRENDERING YOUR GSD BEFORE SUBMITTING THIS FORM.

We receive surrender forms on a daily basis. Unfortunately we do not have the time or staff to contact everyone in order to fill in the blanks for unanswered questions. We would rather devote our time to finding your dog the perfect home; we take that responsibility very seriously. Every answer you provide is important. You are asking for our help & we are here to help; however, we are unable to chase you down in order to provide that help. It is up to you to follow up and schedule an appointment for your dog's evaluation/transport and provide photos of your dog so that we may determine if, indeed, he or she is truly a white German Shepherd Dog. If we do not hear from you within 10 days of receiving your surrender form, we must move on to the next dog needing our help.
PLEASE NOTE: Due to the fact that we are a multi-dog, foster based rescue, we are usually unable to intake dogs that must be kept as an "only dog" or dogs that are aggressive or have a bite record.
Please provide us with the following information - incomplete forms with unanswered questions will be discarded. If you wish to rehome more than one dog, please compete a SEPARATE FORM for each.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

OWNER SURRENDER QUESTIONNAIRE
FOR WHITE or MOSTLY WHITE GERMAN SHEPHERDS ONLY

Please provide us with the following information - you will be unable to submit your form with unanswered questions and/or unless all information is provided.

Legal Owner's Name:
Home Email Address:
Phone Number (Day):     (Evening):      Cell Phone:
Home Address:  (ARIZONA ONLY unless you are willing to assist with transport)

City:   State:   Zip Code:

What are the major cross streets where dog is being kept?

Your Dog's Name:

Is your dog a purebred GSD or a mix?:    Purebred     Mix     Unanswered

Male or female?:    Male     Female
Spayed or Neutered?:    No     Spayed     Neutered     Unknown     Unanswered
If intact, are you willing to have your pet spayed or neutered?:     Yes     No     Unanswered

Dog's Age or Date of Birth:
Dog's Primary Color(s):   (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     No     Unanswered

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 OR THREE 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
Mellow
Happy-Go-Lucky
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?

How did you hear about us?:     Our website     Petfinder     Internet Search     Word of Mouth/Referral     Other     Unanswered
If "Other," please let us know how you found us.

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.

OWNER SURRENDER QUESTIONNAIRE FOR WHITE or MOSTLY WHITE GERMAN SHEPHERDS ONLY
Please provide us with the following information - you will be unable to submit your form with unanswered questions and/or unless all information is provided. Legal Owner's Name: Home Email Address: Phone Number (Day): (Evening): Cell Phone: Home Address: (ARIZONA ONLY unless you are willing to assist with transport) City: State: Zip Code: What are the major cross streets where dog is being kept? Your Dog's Name: Is your dog a purebred GSD or a mix?: Purebred Mix Unanswered Male or female?: Male Female Spayed or Neutered?: No Spayed Neutered Unknown Unanswered If intact, are you willing to have your pet spayed or neutered?: Yes No Unanswered Dog's Age or Date of Birth: Dog's Primary Color(s): (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 No Unanswered 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 OR THREE 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 Mellow Happy-Go-Lucky 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? How did you hear about us?: Our website Petfinder Internet Search Word of Mouth/Referral Other Unanswered If "Other," please let us know how you found us. 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.