Owner's Name*

Owner's Email Address*

Owner's Street Address*

City, State, Zip*

Phone Number*

Alternate Phone Number

Dog's Name*

Dog's Age & Date of Birth*

Spayed or Neutered?*

Current Weight*

Is dog microchipped?*

Microchip Supplier

Type of Doodle*

Generation (ex. F1, F1b, F2)

Color*

Up to date on immunizations?*

Bordetella Due*

Rabies Due*

Flea & Tick Due*

Heartworm Test Last Performed*

Heartworm Preventative - Date Last Given*

Veterinarian Contact Info*

List any allergies the dog has*

List any other medical issues*

Food Currently Feeding*

Reason for rehoming, PLEASE be very honest.*

Can the dog remain with you until a new home is found?

If no, when is the deadline?

Can you assist with transport?*

Dog's skills and knowledge*

Is the dog crate trained?*

Are you still using a crate*?

How long in crate over 24 hr. period?*

Is the dog housetrained?*

Does dog walk well on a leash?*

What type of collar do you use while walking?

Any obedience training?*

Has the dog ever ran away?*

If yes, how many times?

Is the dog currently in a fenced yard?*

If yes, what type of fence?

If you use an eFence, does you dog have any problems with it?

Does your dog get along with:


Does your dog jump on people?*

How does your dog react to strangers?*

Does your dog bark excessively?*

Does dog have separation anxiety?*

How much does your dog shed?*

How would you describe your dog's coat?*

Describe general temperament*

Has your dog ever bitten anyone?
Please provide ALL details.

Where did you get your dog?

Is this the dog's first home (besides breeder)?*

If no, please provide history of where this dog came from:

Name breeder (if applicable):

AGREEMENTS

If any information on this form changes, you will contact us immediately.*
 I agree

If you find a home for the dog on your own, you will contact us immediately.*
 I agree