Cascade Beagle Rescue

Address

Phone Number

Area Code Phone Number
E-mail
DOG INFORMATION
Dog's Name

First Dog Second Dog (if applicable)
Breed
Gender

Male Female
Is this dog spayed/neutered?

Yes No Unknown
Dog's current age
How long have you had this dog?
Describe in detail the reason for surrendering this dog
Dog's beharior traits (check all that apply)

Barks excessively Bite Mouthy/Nips Jumps/climbs/digs under fences Escape artist Rides well in car Housebroken Playful Obedient Smart Sweet, gentle Destroys property Separation anxiety Aggressive towards other dogs Aggressive towards cats/other animals Aggressive towards people/children Good with other dogs Good with cats Good with children 2 and under Good with older children
Describe any health issues this dog has
Date of last rabies vaccine

Month Day Year Date Picker Icon
Date of last DHPP Vaccine

Month Day Year Date Picker Icon
Microchip Brand (i.e. Avid, Home Again, etc)
Microchip Number
Your Veterinarian's name and phone
Do you understand that by completing this form, it does not mean CBR will take your dog?

YES NO - No need to continue if you checked this box
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