About You & Your Dog
First Name
Last Name
Email
Phone
What Region Is The Dog Being Turned In From
Please select...
AB - Calgary
BC - Lower Mainland
BC - Okanagan
Out of Town
Dog Name
Nutrition & Health
Dog Food Brand
Purina
Eukanuba
Other
Please Specify Dog Food Brand
Dog Food Formula
Puppy - Chicken & Rice
Puppy - Large Breed Chicken & Rice
Puppy - Large Breed Lamb & Rice
Adult - DRM
Adult - EN
Adult - HA
Adult - Large Breed Lamb & Rice
Adult - Large Breed Chicken & Rice
Other
Please Specify Dog Food Formula
Frequency & Volume of Food
i.e. 1.5 cups 3x/day
Current Weight (in lbs)
Has Your Dog Had a Fecal Float Done?
Please select...
Yes
No
On what date?
What were the results/treatment?
For example: Clear, or if parasites found please describe (including treatment)
Vaccinations & Treatments
DHPP
Bordatella
Rabies
Other
Giardia, Lyme, etc...
What was given?
Is the Dog on Flea &/or Tick control?
No
Yes - Revolution
Yes - Advantage
Yes - Simparica
Yes - Nexgard
Yes - Bravecto
Yes - Other
What Date Was It Last Given
Is the dog on Any Additional Treatments or Medications?
If so please describe
Does the dog have any chronic health problems?
If so please describe & indicate who diagnosed this problem
Has the dog had more than 2 ear infections requiring a vet visit?
Please select...
Yes
No
Does the dog chew on itself or itch frequently?
Please select...
Yes
No
Has the dog experienced an allergic reaction during puppy-raising?
If so please describe (both the trigger, reaction and the treatment)
Has the dog had/have any other health concerns that have not yet been mentioned above?
If so please describe
Help us get to know the dog being turned in
How difficult was this puppy to raise?
1 - Very Easy
2 - Easy
3 - Average
4 - Difficult
5 - Very Difficult
How many PADS dogs have you raised previously?
Please also include their names as this will give us a means of comparison regarding your previous answer relative to the dog you are turning in.
How long can the dog kennel quietly alone at home during the day?
Does the dog bark at unseen noises?
1 - Never
2 - Sometimes
3 - Often
4 - Always
5 - Uncontrollable
Does the dog bark at people?
1 - Never
2 - Sometimes
3 - Often
4 - Always
5 - Uncontrollable
Does the dog bark at sights/items?
1 - Never
2 - Sometimes
3 - Often
4 - Always
5 - Uncontrollable
Does the dog bark at other dogs?
1 - Never
2 - Sometimes
3 - Often
4 - Always
5 - Uncontrollable
Does the dog bark or growl in other situations?
1 - Never
2 - Sometimes
3 - Often
4 - Always
5 - Uncontrollable
Please describe
Please Describe the dog's personality
What are the dog's strengths? (Training, obedience, and personality)
What challenges are you still working through with the dog? What steps have you been taking to work through these behaviours and what has been the result?
Is there anything you want to tell us to help us know the dog better that has not been covered above?
Your Volunteer Role
Your Volunteer Role
Please select...
Puppy-Raiser
Puppy-Sitter
Would you be interested in puppy-raising again?
Yes
No
Other
Please explain
Contact Information