Stray to Play

stray to play

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Owner Surrender Form

Owner Surrender

Please fill out this form as accurately as possible to ensure a good foster match (if accepted)

A surrender fee may apply

Owner surrender

Your Name

Email

Best number to reach you

Address

Reason for surrender

Dogs name

Breed or Mix (if unknown, best possible guess)

Weight

Age

Gender

Male

Female

Physical appearance - Coat colour, length etc.

Where did you get your dog?

Length of ownership

Any belonging coming along with your dog? Leash, crate, bed, toys etc.

Special needs - Behavioral or physical

My dog has the following health concerns

My dog is currently on this medication

My dog's energy level

High energy

High to medium energy

Medium energy

Medium to low energy

Low energy

My dog is

Spayed/Neutered

Intact

My dog is up to date on all mandatory shots

Yes

No

Not sure

My dog is micropchipped

Yes

No

Not sure

By checking Yes, you certify that you are a sole owner of this dog

Yes

By checking Yes, you understand that if accepted, you will need to sign an owner surrender contract

Yes

By checking Yes, you authorize your veterinarian to release information about me or my pet to Stray to Play as necessary to the evaluation of this application

Yes

Name of vet clinic

Name on records at clinic

Date of last vet exam

BEHAVIOURAL INFO

On a scale from 1 to 5, how would you rate your dog's interactions with other dogs

Agressive 1

2

2

4

5 Playful

Please elaborate if you choose 3 and lower

Can your dog get placed in a home with a cat?

Yes

No

Don't know

Comments regarding dog's interactions with cats

On a scale from 1 to 5, how would you rate your dog's leash skills

Reactive 1

2

3

4

5 Loose leash

On a scale from 1 to 5, how would you rate your dog's interactions with strangers

Don't Approach 1

2

3

4

5 Want pets

Comment

On a scale from 1 to 5, how would you rate your dog's interactions with kids

No kids 1

2

3

4

5 Good

Comment

On a scale from 1 to 5, how would you rate your dog being housebroken

Not at all 1

2

3

4

5 Fully

Is your dog crate-trained?

Yes, great in the crate

Not good in the crate, destructive and loud

Not sure, I haven't been crate-training

On a scale from 1 to 5, how would you rate your dog's separation anxiety

None 1

2

3

4

5 Severe

Please elaborate on your dog's separation anxiety (if present) is your dog loud or destructive?

On a scale from 1 to 5, how would you rate your dog's behaviour during car rides

Bad 1

2

3

4

5 Good

On a scale from 1 to 5, how would you rate your dog's prey drive

None 1

2

3

4

5 High

On a scale from 1 to 5, how would you rate your dog's resource guarding

None 1

2

3

4

5 High

Please elaborate if you choose 3 and lower What type of resourse; food, toys etc.

Your dog is - Please check all that apply

Friendly

Reactive

Agressive

Submissive

Dominant

Protective

Territorial

Obedient

Stubborn

Anxious

Shy

Velcro

Independant

Does your dog have a bite history?

Yes

No

Please elaborate if you clicked yes Was it a handler's error, agression, protective instincts or completely out of the blue?

DAILY ROUTINE

How long is your dog left alone for?

How many walks does your dog get and for how long? Please realistically describe your dog's exercise

What type of food is your dog eating?

How many times is your dog fed per day?

Is your dog allowed on the furniture?

Yes for all

None

Anywhere but the bed

Do you take your dog to the off leash dog park?

Often (multiple times a week)

Once or twice per week

Once every few weeks

Rarely

Never

Please describe a perfect environment and family that you want your dog to end up in

If you had to write a bio for your dog, what would it say?

Advice for new owners

Additional comments

By checking yes, I certify that all information provided in this form is true and accurate to ensure the best possible placement for my dog

Yes

We will do our best to get in touch within 2-3 days. If you don't hear from us, please check your spam.

Oops, there was an error sending your application.

Please try again later

stray to play

STRAY TO PLAY Toronto, Ontario Canada info@straytoplay.org

Stray to Play is a registered charity dedicated to rescuing dogs from all over the globe and finding them loving, lasting homes. We do this by working with volunteers, foster homes and veterinarians, and, of course, our rescue partners.

CRA Registration number: 737551333 RR 0001

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