Form

Turn-in Form

Please complete this form to turn a dog into "In Dog We Trust"
Items we need you to bring in when you bring in the dog.

- Proof of Rabies Cerificate

- Proof of other Shots

- Signature microchip form turn-over sheet [if microchipped]
Owner Information:
Today's Date
Month Day Year
Why are you putting your dog up for adoption?
Full Name
First Name Last Name
Owners Age:

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail
Phone Number
- Area Code Phone Number
Pet Information:
Pet's Name:
Do you know dogs birth date?
Dogs Birth Date
Month Day Year
Where did you originally get your dog?
What gender is your dog?
Is the Dog Spayed or Neutered?
Is the dog housebroken?
Dogs Weight in lbs.?
Dog's Breed:
Dog's Colors
Any special markings?
What are the special markings?
Does the dog have any known fears?
If “ Yes” what are the known fears?
Basic Obedience Training?
Leash Trained?
Any special likes?
What are the special likes?
Any special commands/tricks?
What are the special commands/tricks?
Any bad habits?
What are the bad habits?
Any favorite games or toys?
What are the favorite games or toys?
Which of the following terms best describes your pet? (Check ALL that Apply)

Friendly Destructive Timid Shy Obedient Playful Aloof Finicky Demanding Unruly Loves Everyone High Energy Submissive Lazy Temperamental Digs
Pet Dislikes:
Dislikes Children?
Dislikes Men?
Dislikes Women?
Does your pet get along with other dogs?
Where does your pet spend most of its time?
Has your pet been confined (kennel, chain, fence, etc.)?
Other Questions:
What brand of dog food does your dog eat?
What type of food is it?
Is your dog current on all vaccines?
Is your pet current on all heartworm preventative treatment?
When was the last heartworm preventative treatment?
Month Day Year
Where did you purchase heartworm preventative treatments?
Is your pet current on flea preventative treatment?
When was the last flea preventative treatment?
Month Day Year
Where did you purchase flea preventative treatments?
Any other health problems or anxiety problems we need to know about?
What is/are the problem(s) or anxiety(s)? Please explain:
What is the Name and Phone Number of your veterinarian so that we may request the animal's health records?
Vet Full Name
First Name Last Name
Vet Phone Number
- Area Code Phone Number
Is there a Microchip?
Please check the box below to authorize release of veterinarian records
I hereby authorize the release of my pet's veterinarian records.
Plese submit completed form, we will contact you as soon as possible. Thanks You!
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