Pre-Surrender Form

If you are thinking of surrendering your dog to Green Acres Boxer Rescue of WI, please fill out the form below. Once we receive the completed form, we will be in touch with you. We accept Boxers from Wisconsin (and U.P. of Michigan) residents only! If you live outside our operating area, please contact a rescue organization closer to you.

Please be sure to fill out the form thoroughly! Once you fill out the form, it is helpful if you could email a photo of your dog.

Please note: Filling out this form does not guarantee that GABR will be able to take your dog into rescue.

Owner information:
* Name(s):
Address:
City/State/Zip:
Day Telephone:
Other telephone:
* Email:

Information about your Boxer:
Purebred?	Yes No
Name of dog:
Sex:
Age:
Spayed/Neutered:	Yes No

Up to date on vaccinations:
Rabies	Yes No
Distemper	Yes No
Bordatella	Yes No
Date of late heartworm test:
On heartworm preventative?	Yes No
Name of veterinary clinic:

Where did you obtain this dog?
Name of Breeder:
Name of Humane Society:
Other:
Have you contacted them to return the dog?
How long have you had this dog?
Is the dog good with kids?
Is the dog good with dogs?
Is the dog good with cats?

Other information:
Why are you surrendering the dog?
Any medical problems?
Any behavioral problems?
If you need to surrender the dog by a particular date, please provide the date:
Has this dog ever bitten anyone? If yes, please explain the circumstances.
Has this dog ever nipped anyone? If yes, please explain the circumstances.
Has this dog ever snapped at anyone? If yes, please explain the circumstances.
Anything else we should know about this dog?
	* = Required

site by buildmyownsite.com