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First Name: *
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Last Name: *
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Street Address: *
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Address Line 2:
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City: *
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State: *
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Zip: *
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Phone Number: *
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Cell Phone Number:
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Your Boxer's Name: *
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Boxer's Age: *
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Boxer's Gender: *
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Is the Boxer spayed or neutered? *
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Boxer's Weight: *
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Boxer's Color: *
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Natural or cropped ears?*
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Is tail docked or natural? *
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Where did you get this Boxer dog? *
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How long have you lived with this Boxer? *
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Is the Boxer up to date on vaccines including rabies? *
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When were they last given? *
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Is Boxer up to date on flea and tick prevention? *
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If no, when was flea and tick prevention last administered?
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Is Boxer up to date on heartworm preventative? *
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If no, when was heartworm preventative last given?
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Do you have vet records available for this Boxer? *
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Does this Boxer have a microchip? *
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If yes, what is this microchip number and brand?
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Does this Boxer have any health concerns we should be aware of (such as thyroid issues, food allergies, tumors, seizures, daily medications, needed surgeries, broken bones, malnourished, special diet, etc...)? *
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Please explain in detail. If no, type "Not Applicable." *
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Veterinarian's Name: *
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Clinic's Name: *
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Street Address: *
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Address Line 2:
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Vet's City: *
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State: *
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Vets Phone: *
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Please explain any behavioral or aggression issues. If none, type "Not applicable." *
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Does your Boxer suffer from separation anxiety? *
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If yes, please explain what happens when you leave.
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Does your Boxer display food aggression? *
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If yes, please explain:
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Does your Boxer live inside or outside? *
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Is your Boxer housetrained? *
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Is your Boxer crate trained? *
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Is your Boxer leash trained? *
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Is your Boxer obedience
trained (knows basic commands like Sit, Come, Stay, Down, Heel, etc...) *
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How does your Boxer do with other dogs? *
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Is your Boxer good with cats? *
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Does your Boxer like kids? *
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Please list the other pets your Boxer lives with: *
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Please list the ages of the children you Boxer lives with: *
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How does your Boxer interact with men? *
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How does your Boxer interact with women? *
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To your knowledge, has this
dog ever been exposed to an abusive home or neglectful situation? *
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If yes, please explain:
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Has this Boxer ever bitten anyone? *
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Please explain the circumstances in detail. If the dog has never bitten anyone, please type "Not Applicable." |
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Is this Boxer aggressive towards other dogs or people? If so, please explain in detail. If not, type "Not Applicable" |
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Why are you giving up your Boxer? |
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When does your Boxer need a new home? PLEASE NOTE: FBR, Inc. operates on a foster home-only basis. We do not have a kennel or boarding location where all the dogs stay. We will need to locate a foster home for your dog prior to bringing him into the program. Please allow for a reasonable amount of time for us to locate a foster home. Very rarely can we take a dog the same day this form is completed. *
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Additional Comments:
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I understand that by filling out this form, FBR, Inc. is not obligated to accept my Boxer into their rescue program. I understand that an FBR representative will contact me within one week to discuss the information on this form. I understand that FBR may have suggestions for me or an alternative way to help, such as posting my dog's information on the Owner Surrender page. I understand that if my Boxer is determined to be a good candidate for an available FBR foster home, I will relinquish all claim to my Boxer and allow FBR, Inc. to place him or her into their adoption program. |
Please make a selection.Please select Yes to confirm the above is true. All of the information I provided is true to the best of my knowledge. |
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By clicking on "Submit" you agree to the above statements
and that you have filled out this form to the best of your knowledge. |