We are sorry to hear you are needing to re-home your dog.

Please fill in the following questions in full and we will try to help.

Our waiting list is approximately 3/5 weeks at the moment, and emergencies and welfare cases will take priority.

Please try other rescues in the meantime.

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Name *

Email *

Number

Address *

Dog' name

Breed *

Age & DOB *

Reason for Surrender *

How soon do you need your dog rehomed? *

Did your dog come from another Kennel/Pound? *

If so, which one?

What vet is the dog registered with? *

Microchipped?

If so, what is the number and chip company?

Vaccinations up to date? *

• Yes
• No

When is the next one due? *

Flea/worming up to date? *

• Yes
• No

Neutered/Spayed? *

• Yes
• No

Are there any medical conditions? *

Does the dog like cats? *

• Yes
• No
• Dont’t know

Does the dog like other dogs? *

• Yes
• No
• Don’t know

Is the dog comfortable and safe around children? *

• Yes
• No
• Don’t know

Is the dog nervous or easily stressed? *

• Yes
• No
• Don’t know

Has the dog ever bitten? *

If so, please explain the situation

Can the dog be left alone? *

• Yes
• No
• Don’t know

Is the dog house trained? *

• Yes
• No
• Don’t know

What is most important to your dog?

What is the dog like on a lead/harness? *

What is the dog fed? *

Who lives in the home with the dog at present? *

Does your dog have any bad behaviours/quirks that need worked with? *

Is your dog crated? *

• Yes
• No

Does your dog live inside or out? *

• Inside
• Outside

Is your dog destructive? *

• Yes
• No

Is there anything else we should know about your dog?

Confirmation *

• Yes

I confirm that I am the legal owner of the dog named above and I give full permission for him/her to be rehomed. I understand that once the dog is handed over to BARN Animal Rescue, he/she will not be returned to me under any circumstances.

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