Surrender Form Keep Your Pet During Tough Financial Times! Email Address: (enter only one valid email address):* All questions with an asterisk must be completed for the surrender form to go through.Alternate email address A RECENT picture of your dog is needed before we can accept him/her into rescue. Please e-mail a picture immediately after submitting this form, to robin@smallpawsrescue.org. Until we receive a recent picture of your dog, your request can't be processed. Yes, I will send a picture. Initial and date* First and last name* First Last Your City?* (Without your city AND state we can't process this request).Your State?* Is this dog a Bichon or Bichon Mix?* Yes No Name of Bichon/Bichon Mix in need of rescue:* Dog's Age* Is your dog male or female?* Male Female How much does this dog weigh?* Where did you originally get this Bichon?* Has this dog been spayed or neutered?* Yes No I don't know Can you tell us why this dog needs to be rehomed?*Phone*Best time to reach you?* Morning Afternoon Evening Your relationship to the dog?* Owner Relative of owner Friend of owner Found the dog Other - If other, please explain in the comments section at the end of the form. Housetrained?* Has this dog ever bitten?* Yes No If the dog has bitten, how many times?* Have you sought help from your vet or behaviorist about this problem? Is this Bichon good with children?* Does this Bichon get along with other dogs?* Yes No Is it necessary for this dog to be placed as an only dog?* Yes No Veterinarian's Name* We need your veterinarian's name and phone number. Without that information your request won't be processed. We need to be able to determine legal ownership of the dog.Veterinarian's Phone Number*We need your veterinarian's name and phone number. Without that information your request won't be processed. We need to be able to determine legal ownership of the dog.I give permission for SPR to contact my veterinarian and to get a copy of my dog's vet records.* Yes No I will call my vet office to give them permission to speak with a Small Paws representative. Please initial and date.* Tell us a little about this Bichon's health:* A RECENT picture of your dog is needed before we can accept him/her into rescue. Please e-mail a picture immediately after submitting this form to robin@smallpawsrescue.org. Until we receive a recent picture of your dog, your request can't be processed. Yes, I will send a picture. Initial and date* Is this Bichon or Bichon Mix safe for the time being?* Comments and additional information:
