Surrender
Date
Name
Address
City, State, Zip
Home Phone Number
Cell Phone
Email Address
Name of Basset
Age of Basset
Is the Basset Spayed or Neutered?
Yes
No
Color Description of Basset
Why are you giving up your Basset Hound?
How long have you had your Basset?
Where did you get your Basset?
Is your Basset?
House-trained
Paper-trained
Not House broken
Is your Basset crate trained?
Yes
No
Type of Exercise & duration
How many hours spent outside?
How many hours inside?
Hours left alone daily?
When left alone, where do they go?
Outside
Inside
Either ~ doggie door
Is your Basset an escape artist?
Yes
No
Sometimes
If yes (sometimes) how do they get out?
What are the favorite activities?
Is you Basset obedience trained?
Obedience School
Home Schooled
No Training
Does your Basset come when called?
Yes
No
Does your Basset walk on a leash?
Yes
No
They have their moments
Do they tolerate grooming?
Yes
Usually
No
Is your Basset Protective?
Food
Toys
Other
Not at all
Does your Basset like
Other Dogs
Cats
Children
Does your Basset snap or bite?
Yes
No
Sometimes
If yes or sometimes, please explain
Veterinarian Information
The following best describes my dog
Barker
Outgoing
Destructive
Digger
Whines
Unruly
Jumps on people
Shy/reserved
Hyperactive
Submissive Wetting
Injury/Illness we should know about?
Additional comments