Personal Information
Name*:
Physical Address*: (No P.O. box numbers)
City*:
State*:
Zip Code*:
Cell Phone Number*:
Home Phone Number*:
Email*:
Name of dog*
How old is your dog (date of birth or best guess)*
Gender Male Female
Where did you get your dog* Breeder Shelter Friend
To the best of your knowledge what breed or breeds is your pet*
How long have you had this dog
Is your dog spayed/neutered Yes No
Is your dog current on vaccinations Yes No
Has your dog been heartworm tested Yes No
Is your dog on heartworm preventative Yes No
Who is your vet (name, phone, and address)
Micro chipped (with which company – home again, avid)
Please let us know why you need to relinquish your dog (the more details the better to assist us)
What is the date that your dog needs to be released to amu
Does your dog have any medical issues we need to be aware of
More information about your dog
Has your dog been around children? If so what ages
How does he/she react to them running, being loud, pulling hair etc… please explain in detail
How does your dog react when meeting new people
If he is uncomfortable around one gender, please explain his/her behavior
Is the dog shy, scared, hides or becomes aggressive – please explain
What is his/her behavior when strangers approach
Does he/she know basic commands (sit, down, stay, come or other commands)
Does your dog jump the fence, if so, what height is your fence
How is your dog with other dogs
Does your dog prefer female or male dogs
How does your dog react when meeting a new dog
Have you taken him/her to daycare or dog parks. If so, please explain
How is your dog with small dogs
Has your dog ever been in a dog fight, if so, what prompted the fight. Did your dog start the fight and what was it over
How is your dog with cats
Has your dog been around livestock?
Has your dog been around other kinds of indoor pets (i.e.-- birds, hamsters, rabbits)
When does your dog bark the most (left alone, around strangers, other dogs)
Does your dog show signs of separation anxiety
If so, what does he/she do? Does he/she tear up furniture, destroys things, tries to escape from house
Does your dog get into the trash cans either inside or outside
Have you had a problem with excessive barking
Does your dog dig or destroy your yard when left alone
Is your dog protective of your property
Is your dog afraid of loud noises
What is their reaction to thunderstorms or fireworks
What is your dog’s energy level - high, medium or low
Does your dog like to play with toys such as balls, stuffed toys ect…
What does your dog enjoy doing for exercise or fun
Is your dog protective of his/her things
Has your dog ever shown signs of food aggression toward other dogs or people
If so, what were his/her reaction. Did he/she try to bite
Is your dog crate trained
Where does your dog sleep at night
Is your dog an indoor or outdoor dog
If outside, does your dog ever come in
Has your dog ever bitten a person? If so, explain what happened
Please describe in detail who your dog is both good and bad traits (this will help us to better understand your dog)
Please describe in detail the home you would like to see your dog go to.
Is there any other information that you would like to share with us to help us place your dog
When you submit this application, you are acknowledging that the information given is true and accurate. A representative of amu will contact you to discuss your application and the possibility of us taking your dog within the week of receiving this app. If you do not hear from us within this time limit, please contact us at amudoggies@gmail.com
