Dachshund Rescue of San Diego

of SAN DIEGO

RELEASE

The Dachshund Rescue of San Diego offers shelter, medical attention, and a caring environment for unwanted and needy Dachshunds until a suitable replacement home is found for them. The Dachshund Rescue DOES NOT breed rescue dogs, sell rescue dogs for profit or release a rescue dog for any form of research. Our goal and objective is to place rescue dogs into caring and loving environments and enhance the love of the breed. Any actions contrary to those stated above should be brought to the attention of Dachshund Rescue of San Diego.

BREED: DACHSHUND    NAME: ________________________________________________  SEX: FEMALE MALE

AGE/DOB ___________________________  SIZE: MINI - STD  WEIGHT: ________________________ LBS.

COAT: LONG - SMOOTH - WIRE   COLOR: ______________________________________   ALTERED: Y - N

Received from: Name: ______________________________________________________________________

            Address: ______________________________________________________________________

                     ______________________________________________________________________

              Phone: ____________________(H) _____________________(W) I.D.# _______________

Vaccinations/Dates: DHLP:_______________ Parvo:________________ Corona virus:______________

Bordatella (Kennel Cough):_________________ Rabies current: Exp. Date:_____________________

Allergies: Food, Fleas, Other______________ Other Medical Problems:________________________

Medications:___________________________ Bites/Snaps: Y-N, Barks: Y-N, Digs: Y-N, Chews: Y-N

Jumps fences: Y - N,   Housebroken: Y - N,   Lead broken: Y - N,  Lives: Indoors - Outdoors

Good with: Kids - Other dogs male/female - Cats

Date put into rescue: __________________________  Donation Received $______________________

Reason dog put into rescue: _______________________________________________________________

___________________________________________________________________________________________

Additional comments: ______________________________________________________________________

___________________________________________________________________________________________

I certify by my signature that I am the legal owner of the above named animal. I relinquish all rights to this animal to The Dachshund Rescue of San Diego.

Signature: _________________________________  Date: _______________________________________

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