Foster name
Foster email address
Best phone # to call
Other phone # Days? Evenings?
Preferred Method of Contact
INTAKE DETAILS:
Dog Name
Intake Date
Where from
Age at intake (approx.)
Birthdate (if known)
Other Intake Notes
TYPE / DESCRIPTION:
Breed
Gender
Color
Weight (approx.)
Purebred / Mix?
Other Description Notes
PERSONALITY & CURRENT LIVING DETAILS:
Housebroken? Explain how well
Is dog a chewer?
OK with CATS? If no, describe
OK with DOGS? If no, describe
OK with KIDS? If no, describe
OK with STRANGERS? If no, describe
OK with MEN? If no, describe
OK with WOMEN? If no, describe
OK with CRATE? If no, describe
OK with CAR RIDES? If no, describe
OK with PETTING? If no, describe
OK with TAKING AWAY TREATS? If no, describe
OK with TAKING AWAY TOYS? If no, describe
OK with TAKING AWAY FOOD? If no, describe
OK with TOUCHING FEET? If no, describe
OK with TOUCHING TAIL? If no, describe
Does dog pull on leash?
Is dog afraid of storms?
Does dog show aggression if approached when eating?
Does dog come when called? Sometime, Yes, No
Is dog destructive in home?
Has dog bitten? If yes, details
Temperment or special needs
Where is dog kept most of the time? (house, yard, crate, confined room)
Do you have a fenced yard?
Do you take dog for walks?
What behaviors need improvement? (barking, jumping on people, runs away, fearful of mower/vacuum, etc.)
Does dog know its name?
Does dog know any commands? If so, explain keyword or hand motion
Other Personality / Current Living Details
PLEASE CHECK ALL THAT APPLY:
Friendly
Suspicious
Hyper
Shy
Cautious
Happy Go Lucky
Scared
Protective
Anxious to please
Aggressive
Trainable
Calm
Defensive
Difficult
Driven
Destructive
Stubborn
Quiet
Affectionate
Obedient
Domanant
Outgoing
Lethargic
MEDICAL:
Rabies #
Rabies Date
Rabies Producer / Lot # if known
Rabies Span 1 YR / 3 YR
Is Rabies Tag with dog? If no, where?
Microchip #
Is Microchip tag with dog? If no, where?
dhlpp shot date
Bordatella/kennel cough shot date
HW test Date / Results
Is dog on HW treatment?
Neutered / Spayed?
Dewormed?
Flea Control?
Other medical notes
After hitting SUBMIT... If Sue doesn't have copies of dog's documents/paperwork/shot records... please scan what you have, and: 1) email to Kathy at kc.colvin@gmail.com so I can update our spreadsheet 2) and please COPY susan_hubbard@yahoo.com If your dog is NOT on the website, PLEASE ALSO SEND A PHOTO If you don't have a scanner, please photocopy and mail to: Hubbard's Hounds Dog Rescue PO Box 113 Homer, NY 13077