Dog Evaluation
Registered Name:____________________________Call Name:________________
Sire:______________________________Dam:_______________________________
Birthdate:___________________Breeder:_________________________________
Sex:________Neutered:________Color & Markings:________________________
(Attach photo-copy of registration or blue slip if available)
Date Acquired:____________________From Whom:__________________________
Address:__________________________Phone:______________________________
Shelter_______Placement_______Rescue_______Found________Other_________
Physical Condition: Height_______Weight____pounds (be exact as possible)
Coat Condition:___________________Apparent Injuries:__________________
Veterinary Evaluation:_______________________________________________*
*attach written copy when available
Care Given: DHL [ ] Rabies [ ] Parvo [ ] Vet Exam [ ] Fecal [ ]
Vet Treatment [ ] Heartworm Exam [ ]
TEMPERAMENT: Reactions to: Food:____________________________________
Children:_______________________Adults (familiar)_____________________
Adults (strangers):_________________________Cars:_____________________
Shy?______________________Protective?________When?____________________
Where?___________________________Obedience Trained:___________________
Reaction to Discipline:_______________________________________________
Reaction to Other Dogs:_______________________________________________
Reaction to Other Animals:____________________________________________
Housebroken:______________Does he/she chew?________What?______________
Tendency to be destructive?________Of What?___________________________
Tendency to Chase?_____________What?__________________________________
What height fence does it take to confine this dog?___________________
Recommended type of placement (special conditions, use separate sheet if necessary)
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Signature of Evaluator:_________________________________Date:_________