Record for Foster Home

Rescue Dog #: Registered Name  (if available): AKC Number  (if available): Tattoo Number: Call Name:
Sex: Age: Eye Color: Coat Color and Markings:
Date Spayed or Neutered: Dates of Vaccinations:
Dewormed Date and Drug Used: Method and Date of Heartworm Preventative:
Rescued from: Owner? Shelter? Breeder?
Pet shop? Caretaker? Other?
Reason for Surrender to Rescue: Identified Problems:
Housebroken? Obedience Trained? Good with Children? Other Animals?
Special Medical Problems: Name and Phone # of Attending Vet:
Special Remarks:

Rescue Information

First Contact: Date:
Medical Evaluation: Date: 
Boarding Facility: Date: 
Foster Home: Date: 

Expenses

Veterinarian $ 
Boarding  
Heartworm  
Medication  
Food  
Shipping  
Other  
Total $ 

 

Special Remarks: