Owner Release

Rehoming your Aussie

If you find yourself needing to surrender your Australian Shepherd to Rescue, please complete the following form so that we have complete information on your dog. Also, include at least one picture. Please be aware that we are not able to accept dogs that are Mini-Aussies, Aussie mixes, Aussies with tails, or have any sort of aggression issues.

STAR, AT ITS SOLE DISCRETION, RESERVES THE RIGHT TO REFUSE ANY APPLICANT FOR ANY REASON OR NO REASON.

Dog's Information:

Dog's Name: *

Gender: *

Age: *

Weight: *

Spayed or Neutered: *

Tail: *

Upload Full Body image of Dog (Max: 10MB): *

Registration Number(s):

Color: *

Crate Trained: *

Leash Trained: *

House Trained: *

Barker: *

Digs: *

Fence Jumper: *

Obedience Trained: *

Is this dog on any medication? *

Has this dog had seizures?*

Does this dog have allergies? *

Has this dog been around men? *

Has this dog been around children?*

Has this dog lived with other dogs, cats, birds? *

Dog afraid of thunder? *

Dog afraid of fireworks?*

Dog chases cars? *

Dog food used: *

How much fed? *

AM/PM feeding? *

Dog Aggressive? *

Cat Aggressive?*

Has this dog ever bitten or displayed threatening behavior toward a person? *

Explain any situation where this dog has been aggressive to other animals or people:

Explain where you obtained this Aussie and how long have you owned this dog:

List three things you like about this dog:

List three things you do not like about this dog:

Is there anything you could have done to make this dog more successful in your home?

Where does this Aussie spend the day while you are gone from home?

Where does this Aussie spend the night?

Date of last heartworm pill given:

Type of last heartworm pill and type given:

Owner's Information:

Full Name: *

Email Address: *

Cell Phone: *

Home Phone:

Work Phone:

Street Address: *

City: *

State: *

Zip: *

Veterinarian Information:

Veterinarian Name: *

Veterinarian Phone: *

Veterinarian Address:

Date of last visit to Veterinarian:

Owner’s Printed Name: *

Owner’s Signature: *

Today's Date: *

I understand that if STAR agrees to take possession of this dog, I am agreeing to transfer ownership and possession of this dog and thereby relinquish all right, title and interest in this dog. I pledge that I have faithfully and honestly completed this Release to Rescue form.

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Rehoming your Aussie

Dog's Information:

Owner's Information:

Veterinarian Information: