Welcome to H2H

Re-Home

While we would love to help every single dog, our space is limited. We encourage you to contact us via this form and be added to the wait list of relinquish requests. We do not foster dogs temporarily. Dogs that are signed over to Haven to Home will be made available for adoption.

Submitting this form does NOT automatically transfer ownership of the dog to Haven to Home. A volunteer will be in touch within 48 hours to discuss your options. Calling does not expedite this process.

Please fill out this form for each dog you would like to re-home.

There will be a $50 relinquish fee assessed if we are able to help your dog.

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
-

Email*

Home Phone

Cell Phone*

*=required

Dog's Name?*

Gender?*

Is the dog spayed/neutered? *

Age? Approximate if necessary*

Breed?*

What is the dog's weight/size?*

How long have you had the dog?*

Is the dog microchipped?*

Where is the dog currently being kept? (in a kennel, outside, with family)*

Where did you obtain this dog?*

If you selected stray, above, have you made any attempts to find the owner? Please list any methods you used.

Why are you surrendering this dog?*

What veterinarian, if any, has this dog been seen by? Please provide phone number.*

Has this dog been diagnosed with and/or treated for any medical conditions or diseases?*

Is the dog on any medication currently? (Such as flea & tick, heartworm preventative, special food, or prescription medication)*

Is the dog up to date on rabies vaccine?*

Is the dog up to date on Distemper/Parvo vaccine?*

Does this dog need to be muzzled at the veterinarian?*

Yes	No
not applicable

Has this dog ever growled or showed teeth at a person?*

Yes	No
not applicable

Has this dog ever snapped at a person, but did not make contact with their skin?*

Yes	No
not applicable

Has the dog ever bitten and broken skin?*

Yes	No
not applicable

If you marked "Yes" to any of the above three questions (growled, snapped, bite history), please indicate how long ago this occurred and describe the circumstances:

Has this dog ever displayed aggressive behavior over food?*

Yes	No
not applicable

Has this dog ever displayed aggressive behavior over rawhides, bones, treats?*

Yes	No
not applicable

Has this dog ever displayed aggressive behavior over toys?*

Yes	No
not applicable

If you marked "Yes" to any of the above three questions (aggressive behavior), please describe the circumstances below:

How does this dog react to strangers?*

Has this dog ever lived with children? (Yes or No) If yes, list ages of children:*

How does this dog interact with children?

Unknown; has never been around children	Approaches children without hesitation
Shies away from kids	Barks and carries on when sees children
Growls and acts aggressively towards children	Repeatedly jumps up and is mouthy

What other animals did this dog live with? (No other animals in household; dogs; cats; livestock; other)*

If this dog has lived with other dogs, please provide the following about the other dogs in the household (breed, gender, age):*

How does this dog interact with other dogs in your home?

How does this dog respond to other dogs that it does not live with?

How does this dog respond to cats?

How often and when does this dog eat?*

What brand of food does this dog eat?*

Do you crate this dog? (Yes or No) If yes, how does the dog respond to the crate? (goes right in, needs to be coaxed, runs away, hides, goes in but doesn't settle/barks)*

What specific commands does this dog know (sit, stay, etc)?*

Is the dog house trained?*

If this dog is not housetrained how often does this dog have accidents?

Daily	Weekly
Once in a while

Does this dog use puppy pads? (Yes or No) If yes, where are the puppy pads located in your home?*

Where does this dog sleep at night?*

How long is this dog left alone each day?*

When this dog is left alone, is he/she:

Does this dog destroy things when left alone?*

Yes	No
not applicable

What are this dogs likes: (examples: car rides; digging; fetch; walks; water; quiet time; running; playing with toys)*

What are this dogs dislikes?*

What is this dog afraid of: (examples: cars, children, men, loud noises, riding in cars, vacuum, water, thunderstorms)*

Does the dog enjoy being bathed?

Yes	No
Unknown

Does this dog enjoy being groomed?

Yes	No
Unknown

Describe their energy level: low, medium, high*

Is the dog walked on a leash? If so how often and do they pull?*

Has the dog ever attended training classes or worked with a trainer?*

How long are you able to keep the dog with you?*

Would you be willing to foster until a new foster or adopter can be located?*

If you could choose this dog's new family, what would you say is the ideal home?

Is there anything else you would like this dog's next owner to know?

I understand that this form is not a transfer of ownership but a request for help.*

I agree to supply all available records (vet, AKC paperwork, breeder paperwork, etc.) upon transfer of the dog to Haven to Home Canine Rescue. Please note: Proof of rabies vaccination is REQUIRED.*

I agree to a $50 relinquish fee?

Yes	No
not applicable

I attest that I am the current legal owner of this dog or that I have made serious effort to find the owner of the dog if he/she is a stray and that the information provided in this application is true and accurate to the best of my (our) knowledge. Please sign and date with electronic signature. *

*=required

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