call: 01460 65214 or email: info@ferneanimalsanctuary.org

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Animal Care Dog Form

Unwanted Dog Form

Your details

All questions marked with an asterisk are required
Full Name (Title, first name & last name)*
Address*
Address City County Postcode
Your Email*
Your landline telephone
Your mobile telephone*
Reason to surrender*
Number of dogs being surrendered*
Has your dog been imported from outside the UK?*

If yes, do you have the Pet Passport and proof of all required vaccines / blood tests?
Has your dog ever stayed in a kennels previously? if yes please state frequency and duration.
Are they to be rehomed together?*
- Yes
- No
Is the dog/s microchipped? If yes, is the microchip registered to you?*
- Yes
- Yes, registered to someone else
- No
- Unknown
(please note: if you are not the registered owner we will require a signed letter from the registered owner)
Is the dog/s being surrendered on behalf of someone deceased or who is unable to care for the dog any longer?*
- Yes
- No
(please note: if you cannot attend the appointment to bring your pet in, we will require a signed letter from the registered owner)
If Yes, please state the name and address of the registered owner?
If your dog came to you from Ferne or another rescue please enter the name of the rescue centre.*

please note: if from a different rescue centre, it will need to be returned to them.
How long have you owed your dog?*
- Under 1 month
- 2 to 12 months
- 1 year +
Dog Details
Dog/s Name
Breed
Colour
Gender of dog:*
- Male
- Female
Neutered*
- Yes
- No
- Unknown
D.O.B / Approx. age
About your dog

Please be completely open and honest, as the more we know the easier it will be for us to find the best possible new home for your dog - we understand how difficult this may be for you but please remember that we are here to help you and your pet.
Are there any area of your dogs body that it does not like being stroked*
- Yes
- No
If selected yes, please provide further information
Is your dog good with other dogs when out on walks?*
- Yes
- No
If selected no, how do they behave. Please give as much detail as you can.
Does your dog go off lead?*
- Yes
- No
If selected yes, how do they behave. Please give as much detail as you can.
Does your dog get over excited during play (I.e. play bites)*
- Yes
- No
Is your dog destructive in the home*
- Yes when left
- Yes even when someone is home
- Yes with his own toys
- No
Does your dog bark / howl when left*
- Yes
- No
Does your dog have any behavioural issues (e.g. separation anxiety, aggression, noise fears)*

If yes please give details
How many hours is your dog happy to be left on its own and where does it stay during this time?*
Is your dog good with adults:
- Yes
- No
Are there children in your home:
- Yes
- No
Is your dog good with children:
- Yes
- No
- tolerates them
- avoids
- nervous
Has it lived with another dog before:
- Yes
- No
If yes, was it good with the other dog:
- Yes
- No
Diet & Medical
Usual diet (type & brand of food (dry / wet))
Are vaccinations up to date?
- Yes
- No
- Unknown
(If yes, please bring vaccination card with you)
Date Last Wormed & Name of Product*
Date last treated for fleas & Name of Product*
Name of Vet surgery currently / previously registered with*
Please ask to contact vet to give permission for us to have the vet history.
Does your dog have health / medical conditions or on any current treatment.*

If yes please give details
Please use the box below for any further comments:

Contact Information

Ferne Animal Sanctuary
Wambrook, Chard
TA20 3DH

t: 01460 65214
e: info@ferneanimalsanctuary.org

Charity Number: 1164350

Come and help us

The Sanctuary relies on the goodwill and dedication of volunteers for much of its work and there are many ways that you can help. Please visit the “SUPPORT US” section of our website to find out more.

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We rely entirely on the generosity of people giving whatever they can afford to support our vital work.

Donate today and help provide refuge for unwanted and abandoned animals.

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To make a single donation please click on the enter your amount below and press the button.

Regular gift

Pets offer us unquestioning friendship, and it is sad when they are abandoned by their owners. By becoming a Friend of Ferne Animal Sanctuary you can return some of that friendship. Click the link below to become a Friend of Ferne.

Become a Friend of Ferne

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Name of dog checked-in at

First Name(Required)

Last Name(Required)

Your Email Address(Required)

Do you give consent for Ferne to contact you?(Required)

Yes

No

Are you aged 18 or over?(Required)

Yes

No

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