Dog Personality Profile Dog Personality Profile Form Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Dog's Name* Age (Months)* Age (Years)* Sex* Female Male Spayed Femle Neutered Male Breed* Why are you surrendering this pet?*Where did you get this dog?* This Shelter Friend/Relative Found/Stray Breeder Pet store Internet Offspring of Another Pe How long have you had this dog?* Including yourself, how many people of the following ages has the dog lived with?:Age 0-3 (Female)* Age 0-3 (Male)* Age 4-9 (Female)* Age 4-9 (Male)* Age 10-17 (Female)* Age 10-17 (Male)* Age 18-29 (Female)* Age 18-29 (Male)* Age 30-59 (Female)* Age 30-59 (Male)* Age 60+ (Male)* Age 60+ (Female)* What other animals did your dog live with? (If applicable, please specify how many):No other animals in household No other animals in household Large Dog(s) Large Dog(s) Number Medium Dog(s) Medium Dog(s) Number Small Dog(s) Small Dog(s) Number Cats Cats Number Other Other Type & Number Did the dog co-exist well with other household animals?* Yes No If the answer is no, please explain:Which other animals do you feel your dog can be rehomed/live comfortably with?* Large Dogs Small Dogs Cats Small Animals No other animals Does your dog enjoy visitor dogs inside the home?* How does your dog generally behave toward the following (Check all that apply):Large Dogs:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Small Dogs:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Other Dogs:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Unknown Men:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Unknown Women:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Children 6-12 years old:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Babies 0–6 years:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected Small animals:* Never encountered Friendly Afraid Shows teeth/growls Snaps/Bites None of these Other Describe Other If Selected What would you say your dog's energy level is from 1-10? 10 being very active:*12345678910Does he/she walk well on a leash?* Does your dog do well off-leash? How is her/his recall?* How long is your dog left alone, without people, during an average day?* Never 1-3 Hours 4-8 Hours 9-12 Hours Over 12 Hours When your dog is left alone, is he/she....* Outdoors Free in home Confined to a room In a kennel When left alone, does your dog usually show any of the following behaviors?* Destroy household items Urinate/defecate Bark/cry None of these Is your dog crate trained?* Yes, plastic crate Yes, wire crate Not crate trained Is your dog typically well-mannered in the home?* Is your dog allowed on the furniture?* Where does your dog spend most of his/her time?*Inside the house, free roamInside the house, kennelOutside the house, tie outOutside the house, runs freeOutside the house, fenced areaWhere does your dog usually sleep overnight?* Kennel Floor Dog Bed Couch Owner's bed Does he/she have any basic manners that could use some extra training? (i.e. Barking, Whines, jumping on people, gets in garbage, chewing, guards toys/bones etc.)* How many times do you put your dog out to go to the bathroom?* Does your dog have accidents in the home at all?* What toys does the dog enjoy?* Tennis Balls Frisbee Plush Squeaky Rope toy Rawhides Pig's ears Other Describe Other If Selected What games does your dog like?* Tug Fetch Chase Wrestling None What commands is your dog familiar with?* Does your dog enjoy playing with other dogs?* Yes No Yes, but dog selective Does he/she share toys/water bowls with other dogs while playing?* Yes No What types of dog does your dog get along with? (Check all that apply):* Male Dogs Female Dogs Submissive Dogs Dominant Dogs Large Dogs Medium Dogs Small Dogs Playful dogs Laid Back Dogs Other Describe Other If Selected Does your dog meet with dogs better on leash, off leash, or okay with both?* What “hobbies” does your dog enjoy?* Swimming Dog Parks Long Hikes Skijouring Obedience Trials Beach Days Running/jogging Agility Car Rides Couch-potatoing Where does your dog ride in a vehicle?* Does your dog ride well in a vehicle? Does he/she enjoy it?* Has the dog ever bitten anyone? If so, did the bite break skin and/or require medical treatment?*Has your dog ever injured another animal?*What is the dog's feeding schedule?:* Free feeding 1 time/day 2 times/day 3+ times/day (Please specify how many below) Other Feeding Schedule (Other Information)* What type of food is the dog used to?* Dry Kibble Canned Food Canned/Kibble mix Other Describe Other If Selected What brand of food and flavor is your dog eating?:* How much food is given per feeding?* Does your dog receive table scraps?* Medical HistoryWho is your dog's regular Veterinarian? (If not a local Vet, please provide clinic name, city, state, and if able, a phone number)* Does your dog have to be muzzled at the Veterinarian?* Yes No Check if your dog has ever shown any of the following negative behaviors when handled by a Veterinarian or groomerFull Body Examination* Never Had Done Shows teeth/growls Snaps/bites None of these Administer Shots* Never Had Done Shows teeth/growls Snaps/bites None of these Trim Nails* Never Had Done Shows teeth/growls Snaps/bites None of these Blood Draw* Never Had Done Shows teeth/growls Snaps/bites None of these Teeth Checked* Never Had Done Shows teeth/growls Snaps/bites None of these Ears Checked* Never Had Done Shows teeth/growls Snaps/bites None of these Is your dog currently on any medications? Please list medications and what they are for*Last time your dog was to the Vet and reason for visit:*BraggingTime!! Please share what you love most about your dog and what others would love too!*Upload any veterinary recordsMax. file size: 1 GB. When you surrender to UPAWS, you lose all rights to your unwanted pet. You will not be able to visit or have any decision-making power in the pet’s future care and arrangements. The Owner Surrender Application severs all ties between you and your unwanted pet. UPAWS does not house or re-home animals that are deemed vicious or dangerous to the public. Consent* I have read and agree with the above UPAWS terms
