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Husky Re-Homing

If you need to re-home a Siberian Husky or Siberian Husky mix, please complete this form entirely.  The accuracy of the information you provide is important in matching your dog with the right home.  If you need to re-home more than one dog, please fill out a separate form for each dog and indicate in the comments section if they need to be placed together.  If you are outside our area, we may need to refer you to a local rescue.

Our group feels very strongly about trying to help out where we can.  If you are encountering a behavior problem and wish to try and work things out, we'd be happy to help.  Please contact us and one of our volunteers will contact you as soon as possible.

Husky Re-Homing Request Form

PLEASE NOTE: If you are NOT redirected to a thank you page after you complete your form AND/OR you do NOT receive a confirmation email from us... WE DID NOT RECEIVE YOUR SUBMISSION and we ask you to please try again or contact us directly by email.



Contact Information:

(*) indicates required information.

Full Name (*)

Please type your full name.
Phone (*)

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E-mail (*)

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Mailing Address (*)

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City (*)

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State (*)

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Zip Code (*)

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Dog's Information

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Dog's name (*)

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Dog's age (*)

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Dog's breed (*)

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Sex (*)





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Where does the dog spend the day? (check all that apply) (*)









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Where does the dog spend the night? (check all that apply) (*)










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Why do you want to re-home your Siberian Husky? (*)

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How many hours on average does the dog spend alone without humans on weekdays? (*)

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How many hours on average does the dog spend alone without humans on weekends? (*)

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Veterinarian Information

Please provide us with your current vet information.

Name of Veterinarian

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Clinic Name

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Phone

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Is this the vet you currently use?



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If this is not your current vet, please explain.

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Personality & Behavior



Is this dog house / potty trained? (*)



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Comments about house training:

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Is this dog crate trained? (*)



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Comments about crate training:

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Does this dog get along well with other dogs? (*)




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Comments regarding dog:dog interaction:

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Does this dog get along well with cats? (*)




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Comments regarding dog : cat interaction

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Is this dog food aggressive with other dogs? (*)




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Is this dog food aggressive with humans? (*)




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Comments regarding food aggression:

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Please indicate basic training successes and behavior traits (please check all that apply): (*)













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Please list any types of training you have done with this dog:

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Does this dog get daily walks? (*)



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If yes, how many and for how long?

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Does your dog have any specific fears? If yes, please list them:

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Has this dog ever bitten a human or caused any injuries? (*)



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If yes, who was bitten and what were the circumstances?

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Has this dog ever bitten another animal or caused any injuries? (*)



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If yes, who was bitten and what were the circumstances?

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Fence Information



Do you have a fenced yard? (*)



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If yes, please specify the height and type (check all that apply) (*)










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What is the minimum fence height you'd recommend for this dog? (*)

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If you have a fenced yard, has the dog escaped the yard? (*)



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If the dog escapes this yard, please explain how:

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Health & General Information




Please indicate the date of the last shot or test given

Rabies (*)

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Distemper / Parvo (*)

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Bordetella (*)

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Heartworm Test (*)

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Spay or Neuter date (*)

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Does this dog have any known medical problems (allergies, arthritis, cataracts, dysplasia, etc.)? please list them here:

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How long have you had this dog in your care? (*)

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Please indicate the time frame in which you need to place your dog: (*)

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Please indicate where you got your dog (pet store, breeder, shelter, rescue, etc.): (*)

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Agreement



Are you the legal guardian of this dog? (*)



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Do you agree to allow a representative of Taysia Blue Siberian Husky Rescue, Inc. visit your home by appointment? (*)



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If no, why not?

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Agreement
I / We attest that all of the information provided above is true and correct.

I / We hereby authorize through submission of this form, any veterinarian named above to release any information and records concerning my past or present care of animals to Taysia Blue Siberian Husky Rescue in Nebraska, Inc. I do hereby agree to hold harmless and indemnify said veterinarian for providing such information.

I / We further understand that completing this application does not guarantee that a dog will be placed in rescue with Taysia Blue Siberian Husky Rescue in Nebraska, Inc.

I / We will be asked to sign a transfer of ownership if a dog is placed with Taysia Blue Siberian Husky Rescue in Nebraska, Inc.

I / We agree to allow Taysia Blue Siberian Husky Rescue in Nebraska, Inc to display information about the dog on our website and other advertising opportunities as TAYSIA BLUE sees fit to help in re-homing this dog.





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Name of applicant(s) (*)

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Date (*)

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By pressing the SUBMIT button, you attest that all of the information you have provided in this application is true and correct. Please do not hit the SUBMIT button more than once. You will receive a confirmation page when your application has been processed. If you have any problems submitting this form please email us and make sure you describe what happened.






 
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