Please tell us more about the dog you are surrendering.  It is very important that the below questions are answered truthfully. To ensure the safety of your dog, our volunteers and foster homes, we request full disclosure of your dog(s) history. If Coastal K9 feels that a dog was surrendered  under false pretenses, we reserve the right to return the dog to its previous owners.

Name *
Name
Address: *
Address:
Phone *
Phone
Dog's Information and History - Section 1
If you are unsure, please let us know your best guess.
If you are unsure, please let us know your best estimate.
Please briefly describe any colours and patterns present on the dog's coat.
To the best of your knowledge, if applicable.
To the best of your knowledge, if applicable.
Health and Nutrition - Section 2
To the best of your knowledge. If you are able to, please specify which veterinary clinic.
To the best of your knowledge, if applicable.
Please include the brand if applicable, and type of protein.
To the best of your knowledge. If you are able to, please specify which groomer.
House Manners - Section 3
Please specify if they are crated, sleep on a dog bed, sleep in a human bed, a combination, or any another sleeping arrangement.
If yes, how long are they used to being left alone?
How do they react to being crated? Are they crated for extended hours? Are they crated when left alone? Are they crated at night?
Outdoor Habits - Section 4
Does the dog chase or any of the following? *
To the best of your knowledge.
Does your dog bark at any of the following when on leash? *
Has the dog been exposed to any of the following training tools?
Personality - Section 4
Please check all personality traits that apply to the dog.
This dog is friendly with:
Please select any and all commands the dog knows.
Has your dog every growled over the following?
Does your dog have a bite history with any of the following?