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SURRENDER FORM

To surrender a Great Dane, please complete the following FFGDR Surrender Form.  FFGDR will NOT consider accepting a dog until a surrender form has been completed.  You cannot save your work and come back later, so you must have all information ready or available while submitting your application.  If you are surrendering multiple dogs, please complete a surrender form for each dog.  

This information allows us to have a better idea of why the dog is being surrendered, any behavior issues, health issues, etc.  FFGDR cannot consider placing a dog if we do not have a complete temperament and medical background.  It is critical that you complete the application as all of our foster homes have other pets and/or children and we consider their safety first.  Because surrendered Great Danes are placed in foster homes with other pets and/or children, we cannot accept Great Danes that are aggressive and/or have a bite history (provoked or not).

Completion of this form does not guarantee that Forever Friends Great Dane Rescue will accept your surrendered Great Dane. Because of foster home or fund limitations, it is sometimes necessary to place the dog on a waiting list.  Upon receiving the application, we will consider your Dane for our program and look for a suitable foster home; we will contact you about the status of the surrender.  Be Advised: At the time of the surrender, Forever Friends Great Dane Rescue reserves the right to revoke acceptance of a Great Dane due to aggression, lack of medical records, misrepresentation, etc.

Please understand that we are an all-volunteer organization and that it may take up to 48 hours to get back to you regarding your inquiry. In addition, once we decide to take a dog in it takes time to find a foster home and arrange transport; we will not be able to drop everything and accept your dog. Typically it is not an extremely quick process so be prepared for a wait period before we can accept your Great Dane.

 

Applicant's Name*
Email:*
Cell Phone:*
-
Home Phone:*
-
Address:*
City:*
State:*
Zip Code:*


Please explain the reason for needing to surrender your dog:*


Would you like to make a contribution toward the dog's care while it is in a foster home?
How far are you willing to drive to meet a volunteer?
How soon does the dog need to be surrendered?

General Information

Dog's Name:
Dog Gender:
Age:
Weight:
Color:
If White, is the dog hearing and/or vision impaired?
Ears cropped?
Is the dog purebred?
If no, what is the dog mixed with?
AKC Registered Name:
AKC #:
Is the dog spayed/neutered?
If no, are you willing to donate this cost to the rescue or have it done prior to surrendering?
Is the dog microchipped or tattooed?
Microchip Brand:
Microchip #:

Environment

Has this been the dog's only home?
If no, why did the previous owner give up the dog?
Is the dog house-trained?
If no, please describe why not:
How often does the dog need to go out?
Is the dog crate-trained?
Does the dog potty in his/her crate?
Where is the dog kept when you are not home?
If other place kept when not home, please explain:
Approximately how long is the dog alone each day?
Is the area where the dog lives considered...
Where is the dog normally kept?
If kept in another place, please specify:
Where does the dog sleep at night?
If other sleeping arrangements, please explain:
Can the dog be effectively contained by a baby gate?
Is the dog allowed on the furniture?

Feedings

What brand of food is the dog eating?
How many cups does the dog eat at EACH feeding?
At approximately what time(s) is the dog fed?
How many times a day does the dog eat?
Does the dog have any food/treat allergies?
If food/treat allergies, please explain:

Behavior/Personality

Has the dog been through professional obedience training?
Please list all commands and hand signals the dog knows:
Is the dog good with children?
If yes, please list the ages of children the dog has been around:
If no, please describe the dog's reaction to children:
Is the dog good with the following? (Please select all that the dog is good around, seeing on street, in yard, etc.)
Does the dog do any of the following?
Is the dog... (check all that apply)
Please elaborate on any behaviors requiring explanation:
Is the dog afraid of: (check all that apply)
Does the dog attack noisy things such as the vacuum cleaner, power tools, lawn mowers?
Is the dog destructive?
Does the dog bark excessively or inappropriately?


Has the dog ever bitten or snapped at a person (including children, strangers, visitors, veterinarian, etc.)?
Has the dog ever bitten or killed another animal (including squirrels, rabbits, cats, dogs, chickens, etc.?)
If dog has bitten, snapped, or killed, please describe each instance in detail:
Does the dog live with other animals?
If yes, please list all other animals in the home, sex, and age:
Are any family members afraid of the dog?
If family members afraid, please explain:
Does the dog accept strangers?
Explain dog's acceptance of neighbors:
Does the dog ride well in cars?
Explain how well dog rides in cars:
Is the dog tolerant of other dogs?
Explain whether dog tolerates other dogs:
Does the dog like cats?
Explain dog's reaction to cats:
Does the dog like toys?
Is the dog trained to walk on a leash WITHOUT pulling?
Does the dog resist grooming/nail trimming?
Please list any other unusual behaviors not covered above:

Breeder

Did you receive your dog from a breeder?
If no, where did you get your dog from?
Breeder's Name/Kennel's Name:
Breeder's Phone:
-


Breeder's Email:
Breeder's Website:
Breeder's City:
Breeder's State:
Do you have contact with the breeder?
Have you contacted the breeder about taking the dog back?
What was the breeder's response?

Current Vet/Clinic

Current Clinic/Veterinarian:
Current Clinic/Vet Email:
Current Clinic/Vet Phone:
-
Current Clinic/Vet Address:
Current Clinic/Vet City:
Current Clinic/Vet State:
Current Clinic/Vet Zip:

Vaccinations

Vaccination for Rabies?
Vaccination for Bordatella?
Vaccination for DHPP or DHLPP?
Date of last heartworm blood test:
If positive, did the dog undergo treatment?
Rabies Vaccination Date:
Bordatella Vaccination Date:
DHPP/DHLPP Vaccination Date:
Is the dog currently on monthly heartworm preventative?
Date of the last monthly heartworm pill:
Date of last parasite fecal test:
Results of last fecal:
If positive fecal, did dog undergo treatment?
What type of parasite(s) were they treated for?
What was the treatment used?
What was the date of the treatment?

History

Has the dog ever bloated and/or tortioned?
If bloat/tortion, please list the procedure performed:
Date of bloat/tortion treatment:
Please list all medications and/or supplements the dog is on, the dosage, and the reason:
Has the dog had any other surgeries?
If other surgeries, please describe the procedure performed:
Date of other surgery:
Does the dog have any medical issues or known allergies?
If allergies, please list the issues or allergies and the treatment:
Has the dog been bred?

Releases

By checking the Medical Release box and signing below, I certify that the information I am about to provide is true and correct. Additionally, I agree to call my veterinary clinic and give permission for the release of my pet's medical records to a representative of Forever Friends Great Dane Rescue, Inc.

By checking the Release of Pet Ownership box and signing below, I hereby transfer full ownership, right and responsibility of the dog to Forever Friends Great Dane Rescue, Inc. I understand that after this date I shall have no interest or right to the dog and all decisions regarding the dog shall be made at Forever Friends Great Dane Rescue, Inc.'s sole discretion. I further understand that I am not eligible to adopt the surrendered dog back from Forever Friends Great Dane Rescue, Inc.

By checking the Liability Release & Waiver and signing below, I accept this waiver and release Forever Friends Great Dane Rescue, Inc. from any and all liability. I am certifying that all the answers I have given are the truth. I also understand that this information might be shared with another rescue group if they call Forever Friends Great Dane Rescue, Inc. to inquire about the listed applicant(s).

To the best of your knowledge is the information you provided accurate and truthful?
Is there any other helpful information we should know?
Signature:*
Today's Date:
Prove you are not a robot: