Surrender Questions

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Your Name *

First

Last

Email *

Your Best Phone Number

Dog's Name *

Location of Dog

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

How old is the dog?

How did you get the dog?

Is the dog a pure-bred Golden Retriever?

Is the dog spayed/neutered?

Is the dog male or female?

Is the dog potty trained?

Why do you wish to surrender the dog?

Does the dog get along with new people?

Does the dog get along well with other friendly dogs?

Does the dog get along well with cats?

Has the dog ever bitten or seriously threatened to bite anyone?

Has the dog been in any dog fights?

Does the dog let you take food and toys away?

Does the dog live inside or outside?

away? old else

Is the dog up to date on shots?

Can you e-mail vet records?

On heartworm preventative or on any other meds? Be specific.

Does the dog have any known medical conditions?

Does the dog have any bad habits?

Can a picture of the dog be emailed or mailed?

How long can you keep the dog if we must put the dog on a waiting list?

How did you hear about Love a Golden Rescue?

Is there anything else we should know about the dog?

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