CEDAR VALLEY BOXER RESCUE
Ownership Transfer

No._______________

Dog's Name: ______________________________________________________________________________________________

Description: _______________________________________________________________________________________________

Age: _________________________________ Sex: ____________________________________

Describe the dog's temperament and what obedience training they have had: ____________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

Has the dog ever bitten anyone? If yes give details:

__________________________________________________________________________________________________________

Is the dog current on shots: ___________________________________________________________

Has the dog been on Heartworm preventative/ brand used: __________________________________

When was this last given to the dog? ___________________________________________________________________________

Is the dog Spay or neutered: __________________________________________________________

Does the dog have any known health problems: __________________________________________________________________

Veterinarian used: _________________________________________ Phone #: (_____)______________

How does the dog react to:

Other dogs: ________________________________________________________________________________________

People: ____________________________________________________________________________________________

Children: __________________________________________________________________________________________

Cats/ other Pets: _____________________________________________________________________________________

Any other information you would like rescue to know:

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

I/We __________________________________________________________ do agree that the information given is correct and accurate.
I/We further agree to relinquish all rights to the dog described above to Cedar Valley Boxer Rescue Program and will not make any
attempts to regain the dog.

Owner: ___________________________________________________________________________

Address: __________________________________________________________________________

City/State/Zip: _____________________________________________________________________

Phone Number #: (_____)______________

Rescue Member: ________________________________________ Date: ______________________

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