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Intake Form - English

Please provide complete and accurate information about your dog. Incomplete information may result in your form being rejected. We will get in touch with you as soon as we have a opening in our program.

While you wait for us to contact you, please click here to read this page for important information about our program.

All fields with an * are required.

Your contact information:

First name: *

Last name: *

Address: *

Colonia (if La Paz): *

City: *

State: *

email: *

Telephone:

Cell: *

Basic information about the dog:

Where is the dog fostered? *

If the dog is fostered someplace other than your home, you are responsible for insuring it is fed, watered, taken to the vet, socialized and prepared for adoption. Our volunteers will also need access to the location in order to do a home-check.

If fostered elsewhere, please include location: *

Name of the dog: *

Gender: *

Coat Type *

Size: *

Weight (kgs) - (You must enter a numeric value >0 if you want this dog on the food program:) *

Dog breed: *

Do you want your dog included in the food program? *

Birth date (approx. is ok): *

Unique physical markings (if any):

Behavior!

Good with cats? *

Good with other dogs? *

Good with children? *

Is the dog housebroken? *

Crate trained? *

Leash trained? *

Any car sickness? *

Describe the dog's personality.

Energy level? Destructive with property? Behavior when left alone? Response to strangers? Aggression towards people, other animals, food, etc.? *

History of the dog

When did you receive this dog? *

Where was it found? Physical condition when rescued? Medical treatments received? *

Describe, in your opinion, the ideal Adoptive Home for your dog: *

Health

Spayed/ neutered? *

Spay/neuter date:

Veterinarian/Clinic

As soon as you rescue a dog, you need to take it to a vet. We require documentation from your vet that the dog is free of any diseases that need immediate attention or any apparent injury of lesion that may produce pain or discomfort.

This is not the same as a veterinary record of vaccines. You can take one of these two sample letters to your vet: Sample 1 or Sample 2.

Have you taken the dog to a vet? *

Vet Name: *

Please provide vet contact details (phone or email): *

Final steps

Add a photo of your rescued dog:

Thank you for saving this dog and for taking the time to provide us the most complete and accurate information possible! We want to find a home where this dog will not only be safe, but will thrive! Together we can do it!

*

I have read the Rescue Guidelines

Rescue Guidelines and the Ten Best Practices for Rescuing are excellent resources to get you started.

Close
Intake Form - English Please provide complete and accurate information about your dog. Incomplete information may result in your form being rejected. We will get in touch with you as soon as we have a opening in our program. While you wait for us to contact you, please click here to read this page for important information about our program. All fields with an * are required.
Your contact information:
First name: *
Last name: *
Address: *
Colonia (if La Paz): *
City: *
State: *
email: *
Telephone:
Cell: *
Basic information about the dog:
Where is the dog fostered? *
If the dog is fostered someplace other than your home, you are responsible for insuring it is fed, watered, taken to the vet, socialized and prepared for adoption. Our volunteers will also need access to the location in order to do a home-check.
If fostered elsewhere, please include location: *
Name of the dog: *
Gender: *
Coat Type *
Size: *
Weight (kgs) - (You must enter a numeric value >0 if you want this dog on the food program:) *
Dog breed: *
Do you want your dog included in the food program? *
Birth date (approx. is ok): *
Unique physical markings (if any):
Behavior!
Good with cats? *
Good with other dogs? *
Good with children? *
Is the dog housebroken? *
Crate trained? *
Leash trained? *
Any car sickness? *
Describe the dog's personality.
Energy level? Destructive with property? Behavior when left alone? Response to strangers? Aggression towards people, other animals, food, etc.? *
History of the dog
When did you receive this dog? *
Where was it found? Physical condition when rescued? Medical treatments received? *
Describe, in your opinion, the ideal Adoptive Home for your dog: *
Health
Spayed/ neutered? *
Spay/neuter date:
Veterinarian/Clinic
As soon as you rescue a dog, you need to take it to a vet. We require documentation from your vet that the dog is free of any diseases that need immediate attention or any apparent injury of lesion that may produce pain or discomfort. This is not the same as a veterinary record of vaccines. You can take one of these two sample letters to your vet: Sample 1 or Sample 2.
Have you taken the dog to a vet? *
Vet Name: *
Please provide vet contact details (phone or email): *
Final steps
Add a photo of your rescued dog:
Thank you for saving this dog and for taking the time to provide us the most complete and accurate information possible! We want to find a home where this dog will not only be safe, but will thrive! Together we can do it!
*	I have read the Rescue Guidelines
Rescue Guidelines and the Ten Best Practices for Rescuing are excellent resources to get you started.

Intake Form (English)