QUESTIONNAIRE FOR NETWORKING YOUR DOG

(Please read and follow these instructions. If you have questions prior to posting here, please feel free to contact us at any time. We look forward to providing you a source for networking your ME dog who is in need of a foster or forever home.)

1. Answer and provide as much detailed information as possible for the following questions (may just list answers on the email – do not need to rewrite each question) 2. Include at least one picture of your dog sent as a .jpg file 3. Send all info to a contact under the “Contact” link 4. Look for an email that we are completing and posting your dog on this Website 5. Items in red MUST be completed prior to your dog being posted

Dogs name & location (City/State):

Breed:

Age:

Current weight:

Owners name & location (City/State):

Contact Information (phone numbers, email, FB, etc):

Situation (foster, owned, DVM, boarding, rescue, etc):

Timeframe needed to find a home:

Where you got this dog and how long have you had it:

Medical information (spay/neuter, microchipped, other health conditions):

Where and how ME was diagnosed

Animal hospital (give name if known):

X-rays or barium swallow:

MUST send, with the answers to these questions, pictures (in .jpeg format) of the veterinarian report with diagnosis of your dogs ME in writing and showing what diagnostics, evaluation, and testing was actually done. If suggested, also need pics of any follow-up reports from your veterinarian showing their recommendations for any management ideas, meds to give, further testing needed, any other health issues the dog has or is suspected of having, etc. Include pics of any x-rays and barium study x-rays as all this will be sent to serious potential adopters for the new home so they may verify condition of your dog prior to any decision making. Failure of the potential new home being unable to speak with your veterinarian or have direct contact thru email, fax, or other preferred communication per your veterinarian will result in either not being able to help you network your dog and/or removal of the posting of the dog from all sites and groups where posted.

Food brands and consistency fed (meatballs, milkshake, pureed, etc):

Fed how many times a day:

What position and timeframe is used:

Meds currently taken:

Hydration method and consistency (Knox Blox, Thick It, SubQ, etc):

Items that will go to new owner (Pro Collar, chair, bed, health records, etc):

Miscellaneous

Exercise preferred (if any) and level (high, moderate, low):

Reaction to children, other dogs, and cats:

Leash trained and/or any other training:

Housebroken:

Crate trained:

Pro Collar (or elevation) when not eating and especially at night:

Additional notes (any other pertinent information that will help you decide if you might be safe, loving his forever home):