Surrender Form
Adoptable Dogs


Surrender form

In order to ensure the most appropriate placement for your dog it is important that the information you provide be as detailed and accurate as possible. We strive to place our dogs in situations where they will succeed and your input is vital to our ability to do so.

GSP Rescue New England Surrender Form

Your Full Name
Street Address
E-mail *
Dog’s Name
Is your dog AKC registered? If so, can you provide original copies of their registration?
Name and number of microchip registry if chipped?
Birth Date or approximate age
Where did you get your dog?
Breeder's name (if applicable)
Did you sign a return contract with the breeder? What is their name and contact info?
Why are you surrendering your dog?
House Trained?
Crate Trained?
This dog’s regular veterinarian
Vets Phone #
Does this dog have any physical problems or allergies?
If yes, explain
Is your dog on any medications?
Has your dog ever been on medications or treated for a particular condition? Explain.
Date of last Rabies inoculation?
Date of last Distemper inoculation?
Date of last Bordatella inoculation?
Date of Last Heartworm Test?
Negative or Positive result?
On Which Preventative?
What day of the month is the medication given to your dog?
Your dog’s reactions to
Other dogs
Loud noises
Riding in car
Being alone in car
Walking on Lead
Being alone in house
Being outside in fenced yard
Being alone in fenced yard
Is your dog a digger? Fence jumper?
What does your dog like best?
What does your dog dislike most?
How does your dog act when fearful or unhappy?
Has your dog ever bitten a human?
If yes, explain in detail
If yes, explain in detail
Where does your dog usually sleep at night?
Spend the day?
What brand of food do you feed?
Amount fed and how often?
Has your dog had formal obedience training? If so, list commands known
Has your dog had formal hunt training?
If yes, trainer’s name
List specific hunting commands known and management style used in the field. For example, whistle, e-collar, hand signals, voice commands, etc.
Any bad habits, such as destructive behavior, separation anxiety, excessive barking, etc? If so, please explain in detail
Any other information you wish to share?
When do you need your dog placed by?
We will keep your identity confidential from all adoption applicants. However, do we have your permission to give the person who adopts your dog your contact information?
If yes, what is your preferred method of being contacted? (For example, home or cell phone number, email only, etc. )
Describe the type of home you would want for your dog
Is your dog invisible fence trained? Yes    No   
Do we have your permission to contact your vet and obtain your dog's records? * I agree    I disagree   
To hep us confirm that your dog is a purebred GSP, please upload a recent photo.
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