Golden Retriever Rescue of Mid-Florida

Golden Retriever Rescue of Mid-Florida, Inc
PO Box 1449, Goldenrod, FL 32733-1449
Voice Message Info Line: (407) 332-2840
Email: info@grrmf.org

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Support GRRMF

	All About GRRMF
	Make a Donation
	Join GRRMF
	The Foster Experience
	Become a Volunteer
	Bequests

Adopting a Golden

	Why Adopt a Rescue
	How to Adopt
	Available Goldens

Caring for Goldens

	The Disadvantages of Owning a Golden
	Backyard Safety
	Children and Dogs
	Feeding Your Golden
	Health Facts & Information
	Spay and Neuter
	Fences
	Leashed is Loved
	Puppy Facts
	Obedience Training
	Toys & Treats

Happy Beginnings

Alumni Updates

Other Information

	GRRMF Events
	Surrender a Golden
	Canine Links
	Our Sister Club MFGRC
	Rainbow Bridge

This form can be printed (use the select File, Print on your browser) and faxed toll free to 1-888-408-5520 or you can fill it out online and then press submit at the bottom of the form.
Email intake@grrmf.org if you have any questions.

Owner Surrender Form

We understand that giving up your pet may be a difficult decision, but we realize that in making this decision, you are thinking about your dog’s best interests. We are here to help. Please provide as much information as possible, so that we can find the appropriate home for your dog. Above all, please be honest. Your dog deserves a second chance to find the perfect home, and by providing us with the most detailed information, you will help GRRMF better accomplish this goal.

All questions must be answered--if not applicable or you don't know, enter N/A.

Surrendering owner's name:
Email Address:
Address:
City:
State:
Zip Code:
Phone #:
How often do you check email?
Dog Information
Dog's name:
Sex:	Male Female
Age:
Weight:
Color:
Is the dog spayed/neutered?	Yes No
Where did you get this dog?
How long have you had this dog?
Is it a purebred golden?	Yes No I don't know
Do you have AKC papers?	Yes No I don't know
Is the Pedigree available?	Yes No I don't know
Are vacinations current?	Yes No I don't know
If Yes, which vaccinations are current?
Veterinarian Name:
Veterinarian Address:
Is the dog on heartworm preventative?	Yes No I don't know
If Yes, what brand of heartworm preventative?
What date was heartworm preventative last given?
Has this dog ever had a seizure?	Yes No I don't know
If Yes, how often does the dog have seizures?
Does the dog have any ear problems?	Yes No I don't know
List any orthopedic problems such as hip dysplasia, arthritis, stiffness or difficulty moving around:
Condition of skin - any allergies?	Yes No I don't know
Please list any other medical conditions:
Behavior Assessment
What is the dog's disposition?
Is the dog confident or shy?
Can you take food away?	Yes No I don't know
Can you take toys away?	Yes No I don't know
Can you take bones away?	Yes No I don't know
Does the dog dig?	Yes No I don't know
Does the dog chew?	Yes No I don't know
Does the dog escape from the yard or house?	Yes No I don't know
Does the dog run away?	Yes No I don't know
Does the dog jump fences?	Yes No I don't know
Does the dog jump on people?	Yes No I don't know
Does the dog steal food or items from the counters or tables?	Yes No I don't know
Does the dog swim?	Yes No I don't know
Does the dog ride well in cars?	Yes No I don't know
Is the dog afraid of thunderstorms?	Yes No I don't know
If yes, what does this dog do during a thunderstorm?
Is this an inside or outside dog?	Inside Outside
Is the dog housebroken?	Yes No I don't know
Is the dog crate trained?	Yes No I don't know
Does the dog get along with Children:	Yes No
Does the dog get along with other dogs?	Yes No
Does the dog get along with cats?	Yes No
Does the dog get along with other animals?	Yes No
Is this dog aggressive to other dogs?	Yes No
If Yes, what did the dog do to make you think it didn't like the other dog?
Is the dog possessive over the food dish?	Yes No I don't know
Has the dog ever lived with children?	Yes No
If Yes, for how long?
What were the children's ages?
How did the children treat the dog?
Does the dog accept strangers?	Yes No
Does the dog accept men?	Yes No
Does the dog accept women?	Yes No
Is there anywhere the dog does not like to be touched?	Yes No
Has the dog ever growled or bit a person?	Yes No
Has the dog ever growled at or bit another animal such as a dog or cat?	Yes No
Has the dog ever displayed any other signs of aggression? Please describe below or enter N/A:
Does the dog like to grab your arm or clothes (mouthy)?	Yes No
If Yes, please explain:
Does the dog like to chase bikes or cars?	Yes No I don't know
What does the dog dislike?
What is the dog afraid of?
Has the dog been to obedience school?	Yes No
If Yes, which obedience school?
Does the dog know any commands? Please list:
What are your training methods? Please describe:
Have you ever disciplined this dog when he/she has done something wrong? Please describe:
Home Environment Assessment
Has the dog ever lived with other dogs?	Yes No
Has the dog ever lived with cats?	Yes No
How do you exercise the dog?
Is this dog used to being home alone during the day?	Yes No
If Yes, how many hours on average?
Does the dog have separation anxiety?	Yes No
What kind of food is the dog eating now?
Is the dog on any vitamins or supplements? Please list:
Additional Comments
Why are you giving up this dog? (Please be as detailed as possible.)
What are the areas in which your dog may need more guidance or training?
Please tell us the best things about your dog.
Please note: Please note that GRRMF does not buy or pay for dogs. This is a service to help place your golden retriever in a new home. We do appreciate donations to help us with expenses we incurr. Next Steps: Please read through the form again to ensure you have been as thorough as possible! It will improve your dog’s chance to find a new home. Once the form is submitted a volunteer will be in contact with you to discuss any questions you may have about our process or that we have about your dog. GRRMF is an all-volunteer organization, so we ask for your patience. We are all volunteers and have full time jobs, please be patient. If we can not admit your dog into our program, we will be in contact within 48 hours. If we have room in our program, arrangements will be made for you to drop off your dog or for a volunteer to meet you. We ask that you bring copies of any all veterinary records and any other necessary paperwork at the time you release the dog into our care. Please note that summer months and holiday periods are our busiest times. To expedite the process, you can e-mail photos of your dog to intake@grrmf.org. Please include the dog’s name in the subject line and your name in the body of the e-mail. The photo is only to verify that your dog is, in fact, a golden retriever and will help streamline this process.


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