PLACE A DOG WITH US Fill the form and we will get in touch Placement Form Order Number Dog's Name Gender Male Female Age Size Small Medium Large Breed Purebred Mix AKC papers? YesNo If mix, describe Microchipped? YesNo Chip Manufacturer & Number Altered YesNo Current on shots? YesNo Health History Activity Level Low Average High Housebroken? YesNo Obedience Trained? YesNo Troublesome behavior? Aggressive Not good with dogs Not good with cats Not good with children Digger Barker Escaper Destructive If aggressive, describe Personality Traits Physical Traits Owner's First Name Owner's Last Name Street Address City State Zip Code Phone Number Email Address Reason for placing dog with SRSC Additional Comments
