Surrender Form - Rescue a Golden of Arizona

PLEASE NOTE: WE ARE A BREED SPECIFIC RESCUE. WE CANNOT TAKE IN DOGS THAT ARE NOT GOLDEN RETRIEVERS, OR MOSTLY GOLDEN RETRIEVERS. If your dog does not look like a Golden Retriever, we will be happy to provide you with some other resources for rehoming your dog. Contact us here.

Based on your dog’s background, we match your dog to the best pre-approved family to ensure its well-being. The following questions help us make that match. For the best outcome, please be honest with your answers. NOTE: We do not refuse any dogs because of age, illness or injury.

Date

First Name *

Last Name *

Email Address *

Additional email

Street Address *

City

State/Province

ZIP / Postal Code

Preferred Phone Number - list as home/cell/work *

Additional phone number

Are you the current owner? *YesNo

Is there a co-owner? If yes, please list name and contact information if different than above. *

What is your dog's name? If a pair list both names. *

What is your dog's age? If dogs are a pair, list both ages. Include birthday(s) if known. *

If dogs are a pair, are they bonded (they need to stay together)?

Gender *

What color is your dog? *

How much does your dog weigh? *

Reason for Rehoming? *

Where did you get your dog and how long have you had them? *

If the dog was from Rescue a Golden of Arizona please indicate the original name given to your dog.

If your dog is from another rescue- name of the rescue and location?

If your dog is from a breeder, do they have a return clause?

Present health of your dog? List any medical issues and current medications. *

Is your dog spayed or neutered? *

If female and not spayed, when was her last heat cycle?

List their current veterinarian contact information. *

Is your dog microchipped? *

Are your dog's vaccinations up to date? Rabies / others *

What does your dog eat? How much and how often is your dog fed daily? *

Is your dog housebroken (potty trained)? *

Can your dog use a dog door? *

Is your dog crate trained? *

Where is your dog during the day (Free run of the house/crated/outside/other)? *

Where is your dog during the night (Free run of the house/crated/outside/other)? *

How active is your dog?Very activeActiveCalmPuppy-like

Does your dog go shopping for food on the kitchen counter? *

Does your dog like to dig? *

Does your dog need protective restraining when opening the front door? *

Does your dog enjoy chewing anything besides toys, such as household items? *

Does your dog look for adventure by attempting to jump over or dig under fences/walls? *

Does your dog do alert or more frequent barking? *

How does your dog respond to loud noises, thunder, fireworks? *

Does your dog like to swim? *

What other animals has your dog lived with? (Cats, other dogs, list breed) *

Does your dog ride well in a car? *

Does your dog get car sick? *

Has your dog been to a dog park? *

How does your dog interact with other dogs? *

Will your dog playfully mount other dogs? *

How does your dog greet new people? *

What age of adults/kids has your dog been exposed to? *

Does your dog like kids? *

Is your dog gentle or rough with small kids? *

How easy is it to take food, bones or toys from your dog's mouth? If not easy, how does your dog let you know it's not ok? *

Has your dog ever attacked or bitten a person or another animal? *

Owner will be asked to sign a Surrender form stating the dog has no history of biting or showing aggressive behavior of any kind or will be returned to the owner. *I have read the above statement and agree to the terms and conditions.

Does your dog walk with a collar, gentle leader, harness, chain collar or other? *

Does your dog want to be the leader of the pack and pull when walking? *

Do you have any additional information that will help us match your dog to the best family? *

I hereby declare that all the information provided by me in this document is factual and correct to the best of my knowledge and belief. I understand that any misrepresentation or omission discovered may result in the dog not being accepted for rehoming by Rescue A Golden of Arizona. *I have read the above statement and agree to the terms and conditions.

Please upload a photo of your dog (less than 8 MB) *

No file chosen

Thank you for this information. We know this is a difficult decision, and we will do everything we can to make this as easy as possible. A RAGofAZ intake team member will contact you shortly.