Mid Florida Sheltie Rescue – Relinquish of Ownership

Before filling out this application, please make sure you have time to answer all of the questions carefully and accurately. We want to know all about your sheltie so we can find the perfect home.

If you are ready, please continue filling out the form below.

(Your privacy is important to us. The information we collect below is used privately by MFSR and will never be made public. We do not share or sell your email or other information.)

Please Note: We DO NOT adopt out of the state of Florida. Must be 18.

This application is extensive and may take up to 20-30 minutes to complete. Please keep this in mind before you begin.

Please answer every question completely and as accurately as possible. Please note that if all the questions are not answered your request could be delayed or denied.

    About You

    (PLEASE NOTE: * = required fields)

    *Name:

    *E-mail:

    *Phone:

    Address:

    City, ST Zip:

    How did you hear about us? (Internet, Advertisement, Friends):

    Sheltie Information

    1. Dogs Name?

    2. Dogs Age?

    3. Color? SableMerleTri

    4. Is this dog a male or female? MaleFemale

    5. Is this dog spayed/neutered? YesNo

    6. How much does the dog weigh (best guess)?

    7. Is this dog up-to-date on vaccinations? YesNo

    Does the Dog Like...

    8. Other dogs? YesNo

    9. Cats? YesNo

    10. Children? YesNo

    11. Strangers? YesNo

    12. Going for walks? YesNo

    13. Riding in the car? YesNo

    14. Does he/she get car sick? YesNo

    Do you have any personal comments that you would like to make?

    Has the Dog Ever...

    15. Lived in your house? YesNo

    16. Lived outside? YesNo

    17. Been crate trained? YesNo

    18. Been allowed to run loose? YesNo

    19. Been attacked by another animal? YesNo

    20. Been hit by a car? YesNo

    21. Allowed to breed? YesNo

    22. Been neglected? YesNo

    23. Been abused by a person? YesNo

    Do you have any personal comments that you would like to make?

    Temperament

    24. Friendly? YesNo

    25. Cautions? YesNo

    26. Anxious to please? YesNo

    27. Aggressive? YesNo

    28. Shy? YesNo

    29. Scared? YesNo

    30. Loves everyone? YesNo

    31. Protective? YesNo

    32. Hyper? YesNo

    33. Mostly calm? YesNo

    34. Trainable? YesNo

    35. Will run away if loose? YesNo

    36. Dominant personality? YesNo

    37. Submissive personality?YesNo

    38. Has this dog ever bitten a person? YesNo

    If yes, please explain:

    39. Has this dog ever bitten another animal? YesNo

    If yes, please explain:

    Do you have any personal comments that you would like to make?

    Habits

    40. Housebroken? YesNoSometimes

    41. Barks a lot? YesNo

    42. Digs? YesNo

    43. Escape artist? YesNo

    44. Finicky eater? YesNo

    45. Jumps fences? YesNo

    46. Walks well on a leash? YesNo

    47. Chews? YesNo

    48. Destructive? YesNo

    49. Any other bad habits? YesNo

    50. Tricks? YesNo

    Do you have any personal comments that you would like to make?

    Medical History

    51. Do you currently have a Veterinarian? YesNo

    Name of Vet:

    Vet Phone #:

    52. Approx. date of last vet visit?

    53. Is the dog on any medications? YesNo

    If yes, please list:

    54. Is the dog up-to-date on Heartworm Prevention? YesNo

    If yes, what brand?:

    55. Does this dog have heartworms? YesNoI Don't Know

    Do you have any personal comments that you would like to make?

    56. Items you are sending with the dog (Select all that apply):
    ToysFoodCollarLeashCrateVet RecordsAKC PapersOther

    Mid Florida Sheltie Rescue does not buy or pay for dogs. This is a service to help place Shelties in new homes when their present owners can no longer keep them. This service is free, however, a donation to help pay for expenses is appreciated. In no way will this affect our decision or ability to take this dog.

    57. Please note your donation amount:

    Comments

    If you have any other comments you would like to share with us please leave them here:

    Your Agreement is Required

    I hereby transfer complete ownership of the aboved named Sheltie to Mid Florida Sheltie Rescue. I am giving this dog to Mid Florida Sheltie Rescue knowing that they will place this dog in an adoptive home. I certify that I am the sole, rightful owner of this dog, free and clear of all other interests. I certify that all the information I have given above, is true and complete, and I have not willfully concealed any information about this dog. I hereby forever release, discharge and agree to hold harmless and indemnify Mid Florida Sheltie Rescue, it's board of directors, it's members, officers, and agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of the above named dog.

    My name and phone number may be given to the new owner of this dog, so that the new owner may contact me if he/she wishes, to gain any further information on this dog: YesNo

    I agree that all of the answers I have given, are true and correct to the best of my knowledge.