Pawsitive Steps Dog Rescue

Name of Dog:

Age of Dog:

Colour of Dog:

Weight of Dog:

Sex of Dog:

Male
Female

Has the Dog been Altered?

Yes
No

Rabies Vaccine Date

DHLPP

Bordatella

Heartworm

Flea/Tick

Does your Dog have Health Concerns/Problems?

Yes
No

Please explain the health concerns/problems:

Medications (if any) the dog is currently taking:

Is your dog good with children?

Yes
No
Unknown

Is your dog good cats?

Yes
No
Unknown

Is your dog good with other dogs?

Yes
No
Unknown

Does your dog like to swim?

Yes
No
Unknown

Does your dog like to ride in cars?

Yes
No
Unknown

Does your dog walk well on leash?

Yes
No

Does your dog jump fences?

Yes
No

Does your dog come when called?

Yes
No

Is your dog house broken?

Yes
No

Is your dog crate trained?

Yes
No

Is your dog afraid of storms?

Yes
No

Where does your dog sleep at night?

Where does your dog stay during the day?

Does your dog have separation anxiety when left alone?

Yes
No

Does your dog growl at strangers?

Yes
No

Does your dog let you take food or toys away?

Yes
No

Does your dog know any off the following commands?

Sit
Stay
Down
Fetch

How does your dog behave while being groomed?

How does your dog behave while being brushed?

How does your dog behave while being bathed?

What do you enjoy the most about this dog?

What do you enjoy the least about this dog?

What would be the ideal home for this dog?

Relinquisher Information and Legal

IMPORTANT NOTICE: All owners of the above-named dog must sign this contract before Pawsitive Steps Dog Rescue will agree to take this dog.

Name of Relinquisher(s)

First

Last

First

Last

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email

Phone

In regard to the surrender of the above-described dog, I/We, the undersigned, agree to the following conditions:

By signing this contract, I certify that I am the owner of this dog.
By signing this contract, I understand that this dog becomes the responsibility of Pawsitive Steps Dog Rescue and that I have no further rights to this dog.
All decisions regarding the placement of this dog will be made solely by Pawsitive Steps Dog Rescue.
The Relinquisher has no rights to information regarding the adoption of this dog. Updates on the dog can be provided by Pawsitive Steps Dog Rescue from time to time.

The Relinquisher guarantees to Pawsitive Steps Dog Rescue that this dog’s history with regard to biting is accurately described as follows:

To my knowledge, this dog _______ bitten anyone:

HAS
HAS NOT

Please describe the circumstances:

To my knowledge, this dog _______ bitten another animal.

HAS
HAS NOT

Please describe the circumstances:

If this dog is not current on vaccinations or has not been spayed/neutered, we would welcome any contributions toward the cost of providing this veterinary care.

e-transfer payable to adopt@pawsitivestepsdogs.com