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Peaceful Paws - Owner-Supplied Dog Information

Please please please give us as much information as possible about your dog. The more information we have, the better able we are to help you. Fill out required and non required fields, take some time to give us everything you can think of about your dog.
Owner Information
Full Name/Contact Name

First Name Last Name
Organization Name

Owner/Org Address *

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

Phone Number *

- Area Code Phone Number
E-mail
Dog Information
Dog Name *
Breed *
Mix *

No
If Other or Mix, please specify:
Age *
Gender *

Male Female
Color *
Spayed or neutered? *

Yes No Unknown
How long has this dog lived with you? *
Does this dog have any known medical issues (please explain) THIS DOES NOT MEAN WE WON'T TAKE YOUR DOG, WE JUST NEED TO KNOW *
Vet records are available *

Yes No
Vet contact info *
Where did you get this dog? *

From a Breeder From a friend From a pet store From a shelter or Rescue
If from a breeder, shelter or rescue, please provide contact info
Why are you giving up the dog at this time? *
Dog Personality
Has this dog growled at, grabbed or bitten (either now or in past) *

Dog has growled at family member Dog has growled at stranger dog has air snapped at family member dog has air snapped at stranger dog grabbed (bruised skin) family member dog grabbed (bruised skin) stranger dog bit family member dog bit stranger dog bit family member more than once dog bit stranger more than once No known bite history unknown dog bit child under 5 dog bit child between 5-10
Please check all that apply *

dog is living with small dogs dog is living with large dogs dog has met other small dogs well dog has met other large dogs well dog is living with female dogs dog is living with male dogs dog has met other female dogs well dog has met other male dogs well dog goes to a dog park frequently or ocassionally dog barks and lunges at other dogs while on leash dog has been in a fight with a large dog dog has been in a fight with a small dog dog has been in a fight with a female dog dog has been in a fight with a male dog dog has killed another dog dog has not met other dogs socially dog is unknown with other dogs dog is walked in the neighborhood frequently dog has not lived with another dog dog has been in a dog fight with an unknown dog dog has been in a dog fight with a dog with which it has lived dog has been in a dog fight over a high value item (such as a bone) dog has been in a dog fight which results in a human having injuries
How would you describe his reaction to other dogs? *

curious cautious friendly wants to play barks excitedly growls, hackles up depends on the size of the dog dpends on whether the dog is male or female depends on whether the dog is on leash or not lunges and tries to get to other dog leaps excitedly in the air tries to attack the other dog ignores the other dog never met another dog
Please check all that apply *

dog is living with cats (or has lived with them in past) dog chases cats dog is not good with cats dog has not been exposed to cats dog is unknown with cats dog has only been exposed to cats in the shelter dog has killed a cat Not good with cats outdoors
How would you describe dog's reaction to cats? *

curious cautious friendly wants to play barks excitedly will not leave the cat alone tries to bite the cat lives happily with one or more indifferent to cat no exposure to cats
Please check all that apply *

dog is living with young children (under 6 years of age) dog is living with kids aged 6-12 dog has been exposed to children under 6 yrs of age dog has been exposed to kids aged 6-12 lived with teenagers frequently interacted with kids under the age of 6 frequently interacted with kids under the age of 8 frequently interacted with kids under the age of 12 frequently interacted with teenagers dog does not like young kids dog barks at young kids dog does not like kids running or riding bikes - barks and lunges dog has not met kids under 6 dog has not met kids 6-12 years old dog is unknown with kids
How would you describe dog's reaction to kids? *

Playful Jumps up likes to nip at them afraid of them good with own kids, not good with strange kids avoids them, tries to get away from them shy around them, unsure doesn't like them barks at them growls at them barks at them if they are running or riding bikes never met a kid
Reaction to People *

good with men good with women good with strangers afraid of men afraid of women afraid of strangers doesn't greet strangers well is aggressive with strangers meets strangers enthusiastically is cautious but friendly with strangers unknown history Barks and backs away from strangers Barks and lunges at strangers is crated when company comes over is put away when company comes over doesn't mind friends/relatives coming and going throughout the day doesn't like people just walking in the house loves his family, very affectionate with us not very interested in people, even her family really independent, doesn't really care if we are around or not loves to snuggle on the couch and be part of everything follows us from room to room and won't let us out of her sight
How would you describe dog's reaction to strangers? *

Playful Jumps up likes to nip at them afraid of them good with own kids, not good with strange kids avoids them, tries to get away from them shy around them, unsure doesn't like them barks at them growls at them barks at them if they are running or riding bikes
Please explain further if needed (If dog has growled at or bitten anyone, please explain incidents here)
Is this dog housetrained *

Yes No Sometimes marks in the house Yes, except if he gets really scared or excited
Is this dog *

very active, needs a lot of exercise moderately active, a walk or two a day works well not very active at all, couch potato
This dog *

is walked in the neighborhood frequently Can't be walked - reactive is walked infrequently has never been walked on a leash/rarely walked on a leash used to be walked often but not lately
This dog *

barks when outside digs outside is used to lots of activity i neighborhood
This dog *

is used to visitors once a week or more is used to visitors a few times a month is not used to visitors does not like visitors loves visitors is gated when there are visitors
On average, how long is dog left alone during day? *
This dog *

is crate trained has free run of the house when no one is home is gated in a room is kept outside used to be kept inside but is now outside is kept in the garage is an outside dog, has not been an inside dog other (please explain)
When you get home after leaving the dog unsupervised, do you find, *

nothing out of place. I guess he hangs out on the couch sometimes he chews shoes or stuff we leave laying around he scratches at the doors and windows to get out he barks or cries unil we get home sometimes we find sticky drool in his crate and his nose is bloody or scraped sometimes he pees or poops when we're gone he lives outside, so he's fine
This dog is *

good on leash good on car rides gets sick in the car happy to meet new people concerned about new people afraid of new people barks and lunges at new people happy to go to a dog park has never been to a dog park likes to walk in the neighborhood not good on walks not used to going anywhere outside of home used to walking every day likes to bark likes to dig
Is your dog *

independent calm friendly happy worried afraid clingy energetic jumpy, easily startled nervous fun loving laid back protective loving busy all of the time
Is your yard fenced *

yes, 4 ft yes, 5 ft yes, 6 ft yes, mixed height partially electronic not fenced other
Has your dog ever jumped the fence or does the dog try to dig out from under the fence *

Yes, jumps often Yes, digs Yes, both No, has not jump or dig runs through an electronic fence
is your dog living in *

big city in town in busy neighborhood out in the country in quiet neighborhood
Have you ever taken this dog to a training class? *

Yes No
If yes, where and how did it go?
Are you able to aproach this dog while she is eating? *

yes no people can but not other dogs dogs can but not people
If not, why not (what happens)?
What is this dog's favorite food or toy? *
Are you able to approach the dog while she is eating her favorite food or has her favorite toy? *

yes no people can but not other dogs dogs can but not other people
If not, why not (what happens)?
What is your dog's best quality? *
What is your dog's worst quality? *
What is your dog's favorite thing to do? *
What form of exercise did your dog get regularly? *
Describe you dog's perfect day *
Please provide any additional information that may be helpful
Pretend you had to write an ad to describe your dog. What would it say?
When do you need to place the dog? *
Should be Empty:

Peaceful Paws - Owner-Supplied Dog Information

Owner Information

Dog Information

Dog Personality