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Surrender A Dane

Name: 



Address: 



County: 



City, State and Zip: 



Work Phone: 



Home/Cell Phone: 



Email Address: 




PET INFORMATION
Dog's Name:



Gender:



Age:



Color:



How long have you had this dog?



Spayed/Neutered?



Weight?



Purebred?



If no, mixed with what?



Why do you need to find a new home for the dog?



When do you need to find a home for the dog?



Where does the dane stay during the day? And at night?



Is the dane housebroken? If no, explain: 



Crate Trained?



Donate crate?



Good with big dogs? If no, explain:



Good with small dogs? If no, explain:



Good with cats? If no, explain:



Good with children? If no, explain:



Age of children living with the dog?



Is the dane obedience trained?



Is the dane destructive?



Behavioral problems? Please explain:





Does the dane live with any other dogs? If so, please list breed, gender, age of other dogs:





If the dane has bitten or attempted to bite a person, please give details:





If the dane has bitten or attempted to bite an animal, please give details:





Veterinarian Name, Address and Phone Number:



​Is the Dane spayed or neutered?




Current on Vaccines? Date of last shots?



Current on Heartworm preventative? If not, how long off preventative?



Brand of dog food:



Please email us pictures of your dane to NWFLGDR@gmail.com. Confirm you will send pics:



How far will you transport the dog to rescue?



Know the breeder? Is there a contract with the breeder to return the dane?



Breeder contact info:



Papers?



Can you provide a cash donation to offset rescue expenses? 



Additional information and comments:







​I agree and understand that if Northwest Florida Great Dane Rescue chooses to accept into the rescue the described dog, that I am giving up all rights of possession and ownership of the dog. I agree and understand that this dog will become the sole property of Northwest Florida Great Dane Rescue. I promise that the information I am giving is accurate, and that Northwest Florida Great Dane Rescue will not be held liable or chargeable for any false information or misrepresentations that I may have submitted on this form. I further agree and understand that Northwest Florida Great Dane Rescue will do whatever is necessary for the safety and well-being of this dog.


Type Full Name to serve as signature: