Canine Supplementary Info

Use this form to provide additional, relevant information about the animals to be fostered through our No Pet Left Behind Program. Please note, this form is for dogs only. The Feline Supplementary Information Form can be found here.

Fill in the following information as best as possible and include any information that might be helpful to the foster home while your animal(s) are in their care. Please put “n/a” for any question that doesn’t apply or for which you don’t know the answer. If you have any questions, you can contact Cassie, No Pet Left Behind Coordinator, at [email protected] or 604-506-9297.

CONTACT INFORMATION

Name of Pet Owner *

First

Last

Email *

Email

Confirm Email

Name of Pet *

PET INFORMATION

Please note: The dog’s height/weight may determine the type of foster home .

Pet Age/Date of Birth *

Breed *

Height to Shoulder *

Weight *

Colouring *

Distinctive Markings *

Identification *

E.g., Tattoo/Microchip

How long has this dog been with you? *

How did you acquire the dog? *

If from a rescue, please provide name of the rescue organization.

PET FOOD

Preferred Pet Food Brand *

Preferred Type of Food *

(i.e., wet, dry, raw; certain recipes or ingredients)

Feeding Schedule and Amount *

Preferred Treats *

(i.e., likes, dislikes, special instructions)

BEHAVIOUR/SOCIALIZATION

Has your dog received any training? *

• Yes
• No

At what age and by whom? *

Does your dog climb/jump fences? *

• Yes
• No

Does your dog dig outside? *

• Yes
• No

Does your dog bolt outdoors? *

• Yes
• No

Does your dog react to other dogs/animals/people while on walks? *

• Yes
• No

Does your dog react to visitors/cats/children while inside? *

• Yes
• No

Does your dog sleep overnight in a crate or kennel? *

• Yes
• No

Does your dog remain quiet if left in a crate or kennel while alone during the day? *

• Yes
• No

Has your dog ever suffered from separation anxiety? *

• Yes
• No

Has your dog lived with other dogs and/or cats? *

• Yes
• No

If so, how does it behave with them? *

Has this dog ever bitten or been aggressive? *

• Yes
• No

If yes, please describe... *

How does your dog react acround children? *

EXERCISE

How active is your dog? *

What distance is your dog able to walk? *

Is your dog able to walk up and down stairs? *

• Yes
• No

Is your dog leash/harness trained? *

• Yes
• No

MEDICAL

Please list the most recent dates for the following...

Last vet check-up *

Deflea *

Deworming *

Please describe in detail any existing or previous medical conditions, surguries, injuries, or ongoing treatments: *

Is your dog currently on medication? *

• Yes
• No

Name of Medication(s) *

Condition(s) Being Treated *

Medication Instructions *

(i.e., dosage, timing, warnings)

Has your dog received this medication in the past? *

• Yes
• No

Does this require follow-up vet care? *

• Yes
• No

If so, how often? *

OTHER INFORMATION

Please provide any other information that will assist us in placing your dog in the most appropriate foster home.

Should pertinent details be omitted, we may be forced to remove the pet from foster care. This will be discussed with you.

AGREEMENT

Today's Date *

Date

Time

Request for Service Agreement

• I declare that the information in this Canine Supplementary form is true and complete. I have disclosed all information about my dog that may be needed to ensure its safety and that of the foster home.

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