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One Step Closer Animal Rescue (O.S.C.A.R.)

'Helping you find your new best friend'

Sparta, NJ

Dog Surrender Form


One Step Closer Animal Rescue is a smaller rescue. We focus on dogs scheduled to be put to sleep in shelters but we also work hard to help the local community re-home their pets.

All surrendered dogs must be spayed/neutered, and vaccinated, and must pass a temperament test prior to entry into the program.

______________________________________________

O.S.C.A.R. DOG SURRENDER FORM


OWNER CONTACT INFO
Owner's Full Name:
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email: (*Required*)

INFORMATION ABOUT YOUR DOG
Dog's Name:
Dog's Age: (or best guess)
Dog's Gender Male   Female
Is your dog spayed/neutered? Yes     No
Is this a purebred dog? Yes     No
What breed/mix is your dog?


Where did you get your dog?
    (From a neighbor, friend, newspaper ad, pet store, breeder, rescue/shelter?)



VETERINARIAN REFERENCE

Please provide your dog's Veterinarian Name and Phone Number.
    (Please remember to call your vet and give them permission to talk to us.)

Vet Name:
Vet Phone:
Do you have your dog's vet records? Yes     No


ADDITIONAL INFORMATION ABOUT YOUR DOG


How long have you owned this dog or cared for this dog?


Why do you need to give up your dog? Please elaborate.

Is the dog housebroken? Yes     No


How does your dog let you know it wants to go outside?


How would you rate your pet's energy level?

Very Low       Low       Medium       High       Very High


How would you describe his/her personality? (Check all that apply.)

Happy
Playful
Stand-offish
Friendly
Nervous

Gentle
Fearful
Aggressive
Timid
Calm

Does this dog prefer men or women?

Men     Women     No Preference    


What upsets your dog?


How does the dog act when alone?


Does your dog like to: (Check all that apply.)

Ride In Cars
Rip Up Toys
Play "Keep Away"
Swim
Jump On People

 Dig
Run Away
Play Tug-Of-War
CarryThingsInMouth
Chew Non-Doggy Items

DOES YOUR DOG...
Jump fences? Yes     No
    If yes, how high?



Let you take food or toys away? Yes     No
    Comments:

Let you grab him? Yes     No
    Comments:



Bark when excited? Yes     No
    Comments:



Get along with cats? Yes     No
    Comments:

Get along with dogs? Yes     No
    Comments:

Bark or whine when left alone? Yes     No
    Comments:

Bark or growl at strangers? Yes     No
    Comments:

Hide behind you when meeting strangers? Yes     No
    Comments:

Guard territory? Yes     No
    Comments:

Show fear of thunderstorms or fireworks? Yes     No
    Comments:

Get on furniture? Yes     No
    Comments:

Go in a crate? Yes     No
    Comments:

Live in a kennel or dog run? Yes     No
    Comments:

Allow you to touch his ears? Yes     No
    Comments:

Allow you to touch his mouth? Yes     No
    Comments:

Allow you to touch his feet? Yes     No
    Comments:

Allow you to trim his nails? Yes     No
    Comments:


What parts of your pet's body does he NOT like touched by visitors/guests?


What parts of your pet's body does he NOT like touched by family?


What commands or skills does your dog know? (Check all that apply.)

Sit
Stay
Down
Come
 Walk on Leash
Play Ball
Shake Hands
Leave It


Any other commands or skills?


Has your dog been treated for or do you know if your dog has:

Ear Infections
Eye Problems
Allergies
 Bleeding Issues
Seizures
Hip or Joint Problems


Please describe any other condition that requires medical attention.

Is your dog on heartworm preventative? Yes     No
Is your dog current on Rabies vaccination? Yes     No
Has this dog lived with children? Yes     No     Unknown
    If so, list ages:


Describe how this dog has interacted with children. Tolerate them? Ignore them? Walk away if they get too close? Play with them? Rough or gentle?



Where does your dog stay during the day?
Where does your dog stay at night?


When does your dog bark?


Has your dog ever bitten, snapped at, or attacked a person, dog, cat, or livestock?
Yes     No


If yes, please describe the situation in detail.


What kind of home would be ideal for your dog?


What kind of home should be avoided?


What other information would be helpful for the new owners to know?


How did you hear about One Step Closer Animal Rescue?

_________________________________________________________________________________

I certify that the information I have provided on this form is true, correct, and accurate. I understand and agree that falsification of any of the above information is grounds to disqualify my dog from consideration

Yes       No


Please click on Button to Submit this Form:

_________________________________________________________________________________

ONCE YOU SUBMIT THIS REQUEST YOU MUST EMAIL US A PHOTO OF YOUR DOG.
THE PHOTO MUST BE CLEAR.
OSCARRescue@yahoo.com

The surrender process may take a number of days, due to the need for
confirmation of the information provided.

Submission of a surrender form does not guarantee acceptance of a dog.


One Step Closer Animal Rescue (O.S.C.A.R)     Sparta, NJ     973-810-2853     OSCARRescue@yahoo.com