LOW COUNTRY GOLDEN RETRIEVER RESCUE RESOURCE
Owner or Stray Turn-In

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Please provide as much of the following information as you know about your dog or the stray you have found. Low Country Golden Retriever Rescue knows an owner turning in a golden is a difficult process. Please answer as thoroughly as you can; it helps us in determining the appropriate foster home for this golden.

INFORMATION ABOUT THE GOLDEN RETRIEVER:

Name:________________________________ Age __________ Gender________

Spayed/Neutered: yes no (please circle)
Color _____________ Golden or Mix (circle)

If STRAY, how did you obtain the dog?
___________________________________________________________________

If YOUR DOG or if you know, please circle or answer the response
Good with other large dogs? Yes   No
Good with other small dogs? Yes   No
Good with cats? Yes   No
Good with children? Yes   No
Housebroken? Yes   No
Current with heartworm? Yes   No
(what kind of treatment used) ______________________________________
Current with Rabies? Yes   No
Current with other shots? Yes   No
Loud Noise/Thunder phobic? Yes   No
Like car rides? Yes   No
Are there any other medical issues we should know about? ____________________________________________________________________
Are there any other behavior issues we should know about?
____________________________________________________________________
Has this golden ever bitten anyone?  Yes   No
Any other general disposition information we should know?
____________________________________________________________________
What is your reason for surrendering your golden?
____________________________________________________________________
____________________________________________________________________

CONTACT INFORMATION

Your name__________________________________________________________
Your telephone number______________________________________________
Your cell number __________________________________________________
Your town/city of residence________________________________________
Your email address_________________________________________________

THANK YOU for your help!

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Return completed form to:
LCGRR,  P.O. Box 31256, Charleston SC 29417
(843) 571-7717