PHONE SCREENING FOR DOGS NEEDING HOMES

Caller:_________________________________________________________________________________

Date:___________________________

Address: ______________________________________________________________________________

Referred by: ___________________________________________________________________________

City, State, Zip:_________________________________________________________________________

Telephone No.: _________________________________________________________________________

What is the source of the phone call (e.g., owner, shelter) ________________________________________

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Has the dog been confirmed as a purebred Scottish Terrier? ______________________________________

Is the dog AKC or CKC registered? ____________ Is this dog a Scottie cross? ______________________

Is the breeder known? ____________________________________________________________________

If so, what is his/her name, address and phone number and has he/she been contacted?________________

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Why does this dog need a new home?_______________________________________________________

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Is the animal male/female?________________________________________________________________

How old?______________________________________________________________________________

Has the animal been neutered/spayed?_______________________________ If so, is there proof?________

What is the dog's height and weight?_________________________________________________________

Does the dog have any medical problems?_______________ Are health records available?______________

Does the dog have any behavioral or temperament problems?_____________________________________

If so, describe:__________________________________________________________________________

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To your knowledge has this dog ever bitten anyone?____________________________________________

Is foster care needed? If so, by what date?___________________________________________________

NOTES: ______________________________________________________________________________

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