Dog Adoption Consent Form

Animal Details

Species: Canine

MaleFemale

Neutered:

YesNo

Is your dog Welsh speaking?

YesNoBi-lingual

Owner Details

Dog Sociability

Is the dog good with:

Young childrenTeenagersOther DogsCatsRabbits/Guinea PigsChickens/DucksLivestock

Has the dog bitten in the past?

YesNo

Is the dog possessive?

YesNo

Obedience/Behaviour

Can be left aloneBasic CommandsOK on leadBasic recallDestructivePlays with toysGood with travellingHouse trainedAccepts groomingUsed to being crated

HarnessCollar+LeadHalti type

Health/Vet History

Vaccinated:

YesNo

YesNoCard Present

GoodPoorAverage

Worming:

YesNo

De-flea'd:

YesNo

Consent

I/We hereby agree to relinquish all rights to ownership/keepership of the above animal(s) from this day forward, & understand that no data relating to the animal's new owners will be given to me/us by Animal Rescue Cymru.