Surrender Form - French Bulldog Rescue of Ontario

Contact Information

Personal Info

First Name *

Last Name *

Contact

Phone *

Email Address *

Address

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

FBRO Rescue offers two rehoming options. Which is suitable for your needs? *Surrender this dog into our careKeep dog with you with FBRO Rescue rehoming assistance

Dog: Basic Information

What is the name of the dog? *

Age *

Breed / Mix *

Colour / Markings *

Approximate Weight *

Gender *MaleFemale

Is this dog Spayed/Neutered? *YesNo

What is the date of last heat?

Date of last Vaccination (or titre check) *

DHPP vaccination date *

Rabies vaccination date *

Other vaccinations & dates

Treating Veterinarian

Veterinarian information

Name

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Ownership

Is this dog microchipped or tattooed? *YesNo

Please provide number/registry dog and owner name registered under

Are you the owner of this dog? *YesNo

How long have you owned this dog? *

Where did you get him/her? *

Reason for Surrender *

Do you have a breeder contract that includes rehoming conditions? *YesNo

Has the breeder been notified?YesNo

Dog: Training, Behaviour & Care

This dog is (check all that apply)HousebrokenPaper TrainedSometimes has accidentsHousetraining Required

Is this dog crate trained? *YesNo

Do you walk/exercise the dog regularly? How often? *

Where is the dog kept when you’re not at home? *

Where does the dog sleep at night? *

How many hours a day is the dog left alone? *

How does the dog behave when alone? *

What are the dog’s favourite activities? *

What training has the dog received? (Choose one or more)Obedience classesOwner trainedIndividual professional trainingTraining required

Known Commands (provide list) *

Training Language *EnglishFrenchHand signalsOther

This dog has lived in home with:DogsCatsBirdsOther animals

This dog has lived in home with children aged:Under 55 - 1213 - 16Older

Adults (ages) *

How does the dog get along with those listed above? (Describe any issues or concerns) *

Is the dog protective of its food/toys/treats/family/property? *YesNo

How does the dog react to strangers outside and inside the home? *

Has this dog snapped at or threatened a human or other animal? *YesNo

Describe circumstances.

Has this dog bitten a human or animal? *YesNo

Describe circumstances and severity of bite.

What is the dog fed, how often, and how much? *

Does this dog have any special needs or health conditions? *YesNo

Please list / describe.

List any medications or special food/shampoo/care requirements:

Is there anything else that you believe we should know about this dog?

Submission Date

Surrender / Rehome Application

Contact Information

Dog: Basic Information

Treating Veterinarian

Ownership

Dog: Training, Behaviour & Care