Bear

Jeff Kolbjornsen

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Bear is a 16 month old male neutered Rottweiler. Bear is in need of a home desperately since he has a limited time in his adoptive home. He scheduled to be destroyed by his new owners based on his behavior. The rescue group has decide not to take Bear back regardless of owners plead to return him. Time is on the essence, he will be put down unless he is re-home. We are looking for someone with large dog experience and is very familiar with the breed. Please contact the Blue Point-Bayport Animal Hospital and to speak to Dr. Lani Ramsden at 631-472-1101.

Bear's Foster/Adoption Application

Name *

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Last

Address *

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City

State

Zip Code

Country

Email *

Home Phone Number *

Cell Number *

Work Number *

Marital Status *

Married Singal Divorce

How many people in your household *

If so, How many Children ad Adults *

Do have other pets and how many (Dogs, Cats, etc): *

Are they all spayed/neutered *

Where do you live? *

House Apartment Condo Townhouse Other, then specify below

If you click other then specify here *

Do you Rent or Own *

Rent Own

If you Rent, do you have the Landlord's permission to have a dog *

YES NO

Do you have a fence *

YES NO

What type of fence *

How tall is the fence *

Do you have a pool *

YES NO

Is the pool fenced off *

YES NO

What Brand of Food will you feed your dog *

How much time will your dog be outside *

How much time will your dog be indoors *

What percentage of time will your dog be left alone *

Where will your dog be left when alone *

Where will your dog sleep at night *

What area of the home will the dog be allowed *

Under what Circumstances would you give this dog away to a friend or family member? *

Having a Baby Breakup/Divorce Moving Dog bites a person Dog bites a animal Change in circumstance ( Laid off, etc) Behavior Problems ( barking, digging, potty accidents, etc) Dog is sick and expenses too high There's no circumstance which I would give this dog away Other

Under what Circumstances would you surrender this dog to the animal shelter? *

Having Baby Breakup/Divorce Moving Dog bites a person Dog bites a animal Change in circumstance (Laid off, etc) Behavior Problems ( barking, digging, potty accidents, etc) Dog is sick and expenses too high There's no circumstance which I would give this dog away Other

Other ( Explain ) *

Veterinary Information *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

I the undersigned, hereby sign acknowledging the above is true and accurate, *

YES

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