AZBHR Owner Relinquish Dog Information Form

Please use this form to provide information to Arizona Basset Hound Rescue about your basset hound. By filling out this form, you are providing information ONLY. This form DOES NOT constitute an agreement for Arizona Basset Hound Rescue to take in your dog. After the form is received by AZBHR, a volunteer will contact you with more information about the relinquish process.

Note: If you are using AOL or Compuserve, this form will not work - it will send a blank message. Please cut and paste the questions into an e-mail and send it to info@azbassetrescue.com.

Enter Your Name:

Dog's Name:

Today's Date:

Rabies Tag Number/County:

Date of Spay or Neuter:

Date of Rabies Vaccine:

Date of Distemper Vaccine:

Date of Bordatella Vaccine:

Name and Phone Number of Veterinarian:

Known Health Issues:

Dog's Approximate Age or Birthdate:

Dog's Coloring: Red & WhiteTricolor

Information About Dog's Personality. Please try to be as specific as possible:

Is the Dog Leash Trained? YesNo

Notes About Leash Training. Please try to be as specific as possible:

Is the Dog Good With: [check all that apply] Males Females Teenagers Children Cats Male Dogs Female Dogs

Is the Dog Housetrained? Yes No Partially Doggie Door

Other Known Information [check all that apply]:

Gentle Dependent Energetic Confident Playful Silly Serious Protective
Quiet Easygoing Dominant Stubborn Destructive Chewer Escape Artist
Jumps Up On People Digs Plays Rough with Humans Aggressive Nervous or Shy
Aloof Bites or Nips Submissive Noisy Sheds Drools

Which environment do you think this dog would do best in?
Calm, Fairly Quiet Moderately Active Very Active

Type of Food and Feeding Schedule:

Please provide information about why you need to relinquish the dog: