First name *
Please Note: You must enter one contact number
Phone number *
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Is he/she neutered?
Is he/she up to date with vaccinations?
Is he/she up to date with vaccinations? Please note: You must have proof of vaccinations by means of a vaccination card signed by a vet. If you do not a fee will apply.
Has he/she been vaccinated against kennel-cough?
When was he/she last deflead?
When was he/she last dewormed?
Has your dog had any illness, injuries, undergone any surgery or any insurance claims?
If YES give full details below:
Reason for surrendering your dog:
Has he/she ever bitten anyone?
Has he/she ever bitten another dog?
Please be completely honest with the details you are providing us with. Please insure to include any incidents that may have happened as we need to make sure that we place the dog in the right home.
Name of your vet?
When was your dog’s last vet visit?
To help the DSPCA place your dog in the right home please provide information about the dog’s temperament, personality, likes, dislikes and what training your dog has received: