Shelter name:
Location of Shelter (city and state):
Contact e-mail:
Phone:
The dog's name
Is
this a male or a female dog?
choose one
male
female
Is
this dog spayed/neutered?
choose one
yes
no
Do you have a vet that spays/neuters at you facility?
choose one
yes
no
List any fee charged to rescues for a spay/neuter by a vet
at your facility:
If there is no vet that spays/neuters for your facility,
and there a local vet in your area that spays/neuters at
a reduced cost for dogs going into rescue, please list their
fee:
Is the dog HW negative?
choose one
yes
no
If the dog has not been tested, can he/she be tested at
your facility or by a local vet? (Note: we cannot accept
dogs that have not been tested and found to be hw negative)
choose one
yes
no
If there is a fee associated with a hw test? List it here:
Does
the dog have its rabies vaccine?
choose one
yes
no
What othere shots does the dog
already have?
What shots can be provided free of charge prior to transfer?
If some shots can be provided at a cost, please list these
shots and their associated fees:
What is the age of
the dog? (approximate if necessary)
Where did the dog
come from? (owner turn-in, animal control, etc)
Describe the markings
of the dog (black/tan, all white, all black, etc):
Explain any known behavior problems
this dog may have (not good with cats, etc):
Is this dog pictured
on Petfinder? If so, give us the Petfinder url for your organization:
If you have a photo of the dog available,
upload a photo here:
Please provide us with any
other information you think is pertinent:
Note: After
submitting this form, you should be taken to a page that states "Thank
you for submitting your online form.
CI GSD Rescue
is a registered, incorporated, Not For Profit Organization
in the State of Illinois. All Donations are tax-deductible.
