Surrender Information

Please tell us about the dog that you would like to surrender to Great Dane Rescue NE Florida. As soon as we receive your information, a representative from Great Dane Rescue NE Florida will contact you.

NOTE: We have extremely limited fostering capability. We still encourage owners to contact us so that we can try and assist them, but this may mean trying to work thru a problem or possibly listing the dane for them.

CONTACT INFORMATION
	Email Address
	Name
	Street
	City
	State
	Home Phone
	Alternate Phone	ext.
DOG INFORMATION
	Name
	Age
	Color
	What gender is the dog?	Male Female
	Is the dog:	Neutered Spayed Intact
	Cropped Ears?	Yes No
	How long have you had the dog?
	Is the dog a purebred great dane?	Yes No If not, what breed(s) is the dog mixed with?
	Why do you need to find a new home for the dog?
	When do you need to find a home for the dog?
	Where does the dog stay when you are home?
	Where does the dog stay when you are gone?
	Where does the dog stay at night?
	Is the dog housebroken?	Yes No
	Is the dog crate trained?	Yes If so, was the dog only crate trained as a puppy? Yes No No
	Is the dog still crated at certain times?	Yes If so, when? No
	Will you be able to donate the crate to rescue?	Yes No
	Is the dog good with:	Big dogs: Yes No Don't Know Small dogs: Yes No Don't Know Other animals: Yes No Don't Know Please explain: Cats: Yes No Don't Know Children: Yes No Don't Know If so, what ages has the dog been around?
	Does the dog live with children?	Yes If so, what ages? No
	Is the dog obedience trained?	Yes No
	Does the dog ride well in the car?	Yes No
	Does the dog walk nicely on a leash?	Yes No
	Is the dog destructive?	Yes If so, please describe: No
	Describe any behavioral problems:
	How does the dog act when meeting new people?
	Is or has the dog lived as an only dog?	Yes No What age, size, and sex have the other dog(s) been?
	Name of the dog's vet:
	Phone number of the dog's vet:
	If more than one vet, other vet's contact information:
	May we contact your vet(s) for information pertaining to this dog?	Yes No
	Is the dog current on shots?	Yes No
	Date of last shots
	Is the dog on heartworm preventive?	Yes If so, what kind and when was it last given? No If not, how long has the dog been off preventive?
	Explain any medical problems the dog has:
	What brand of dog food are you feeding?
	How tall is the dog at the shoulder with all four feet on the floor?
	How much does the dog weigh?
	Can you email pictures of the dog?	Yes No
	Can one of our rescue volunteers come to meet the dog?	Yes No
	How far are you willing to help transport the dog to the rescue?
	Do you know the breeder of the dog?	Yes No
	Who is the breeder?
	Are you under contract with the breeder to return the dog if you cannot keep it?	Yes No
	Do you have papers for the dog?	Yes If, so what kind (AKC, UKC, etc.) No
	Has the dog ever bitten or attempted to bite another person?	Yes If so, please explain: No
	Has the dog ever bitten or attempted to bite another animal?	Yes If so, please explain: No
	Can you give a donation to rescue to help cover the cost of caring for the dane while in rescue? (example: crate, blankets, heartwom and flea/tick prevention, monetary donation, etc.)	Yes No
	Additional information