Dog Pre-Admission Form - Borders Pet Rescue

Name of owner (required)

Address (required)

Town (required)

Postcode (required)

Telephone (required)

Email address (required)

Name of dog/s (required)

Breed of dog (required)

Age of dog (required)

Sex of dog (required)

Male

Female

Is the dog neutered (required)

Yes

No

Unknown

Is the dog vaccinated (required)

Yes

No

Unknown

Date of last vaccination (required)

Is the dog microchipped (required)

Yes

No

Unknown

Is the microchip registered to the owner (required)

Yes

No

Unknown

If not microchipped, or details not in your name, why/who is the dog registered to

What is the dog normally fed (required)

Meat (tinned etc)

Kibble/Dry food

Other, please explain:

Does the dog live in the house (required)

Yes

No

Is the dog used to being left (required)

Yes

No

How long left alone, if any (required)

How does the dog react to being left alone (required)

Has the dog stayed in kennels before (required)

Yes

No

Is the dog walked on lead (required)

Only on lead

Only off lead

Both

Has the dog lived with other dogs (required)

Yes

No

Unknown

Does the dog get on with other dogs (required)

Has the dog lived with cats (required)

Yes

No

Unknown

Does the dog get on with cats (required)

Has the dog lived with children (required)

Yes

No

Unknown

Does the dog get on with children (required)

Age of children lived with/used to (required)

Any behavioural issues (required)

Any medical issues (required)

Reason for rehoming (required)

How long have you owned the dog (required)

Where did you get the dog from (required)

If a breeder/rescue, have you been in touch with them (required)

Are you able to bring the dog into us (required)

Yes

No

If more than 1 dog, should they be rehomed together

Together

Separate

Either

Any other comments

I confirm that I have read the Borders Pet Rescue Privacy Statement

(See link below)

Type the characters (required)