This is a request for information, not a transfer of ownership. Please be advised that the number of owner surrenders makes it difficult for us to take all the dogs we are asked to take. If you obtained your dog from a breeder or another rescue, your first point of contact to relinquish the dog should be them. Our first priority is to dogs adopted out from National Great Pyrenees Rescue (NGPR).
We are asked to take many dogs we cannot accommodate. If your dog was not adopted from our rescue or if an NGPR volunteer did not ask you to complete a form, you may want to look for other alternatives on our rescue contact list, nationalpyr.org/contacts or visit nationalpyr.org/surrenders for other options, including social media groups. Please note many shelters are full and will euthanize owner surrenders shortly after arrival as they are only required to hold strays.
If the dog was found as a stray, many states require that strays be reported to the nearest shelter, although with shelters so crowded they may ask that you continue to hold the dog whenever possible. If you are completing a form for a stray we understand that you may not be able to complete all the questions. Please complete as many as you can. Thank you.
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Work Phone x
Cell Phone
Alt Email
How did you hear about us:
Dog's Name:
Dog's Sex: Choose one: Female Male Neutered Male Spayed Female
Is this dog spayed or neutered?
If the dog is an unspayed female, when was this dog's last heat?
Dog's Age: (Indicate if approximate or actual age)
Does the dog have AKC Papers?
Does the dog have a microchip? Please list the vendor and chip number if known.
Dog's Description: Please describe the color and markings (white, white with grey badger face etc.)
Does the dog have double dew claws:
If the dog came from National Great Pyrenees Rescue, please list the dog's name at the time of adoption, the date and what state the dog came from:
If the dog came from a breeder, please list the name, city, state and contact information for the breeder:
If the dog came from another rescue or shelter, please list the name, city, state and contact information for that organization:
If the dog came from a pet store, please list the name, city, state and contact information for the store:
If this dog is a stray, please describe how you found the dog and whether you have made any attempt to search for the owner. (Ex. put up posters, search for owner on Craig's list, notify local shelter, etc.) List any methods used.
How much did the dog cost? (If applicable)
Please tell us your reason(s) for surrendering the dog. You will have the opportunity to describe any particular incidents or events in detail later on in the form. *
Have you worked with trainer or behavioralist?
Please be specific about the actions that have been taken for training and assessment of your dog's issues as described above. If you have worked with a trainer or behavioralist, please give the name and contact information for that person.
We understand that no dog is perfect. Please answer the following questions as honestly and accurately as possible so that we may better help in placing this dog in the best possible environment. Incomplete forms will not be accepted. Is the dog a:
Where does the dog spend the majority of its time?
How long have you had the dog?
Where does the dog sleep?
How is the dog contained?
If the dog is contained by a fence, please indicate height and type of fence:
Has the dog ever escaped or jumped a fence? (select all that apply)
If the dog has jumped a fence, please indicate height of fence and type of fence (stockade, picket, wire, electric etc.)
Will the dog run if loose?
Is the dog crate trained?
If the dog is crate trained, please indicate how often, how long, and the last time the dog used the crate
Is the dog house trained?
Will the dog walk quietly on a leash?
Will the dog come when called? (select all that apply)
Does the dog get along safely with cats? (select all that apply)
Does the dog get along safely with other dogs? (select all that apply)
Does the dog get along safely with children? (select all that apply)
Does the dog get along safely with strangers? (select all that apply)
When food or treats are present, does the dog (select all that apply)
What is the dog fed? Please indicate can or dry, brand (Purina ONE, Purina ProPlan, Alpo, whatever was left over from dinner etc.) and quantity and how often.
Would you describe the dog as
Is the dog destructive in the home (select all that apply)
Please describe any destructive behaviors
Does the dog become anxious when left alone?
Please describe your dog's behavior when left alone (anxious if left in the home alone, anxious if tied outside and you leave, etc.)
Is there any history of aggressive behavior toward people?
If you answered yes, please describe the aggressive behavior in detail and any events leading up to it.
Is there any history of aggressive behavior with other animals?
If you answered yes, please describe the aggressive behavior and type of animal involved
Please tell us everything you can about the dog's history, personality traits, training, quirks, etc.
What is the current weight of your dog (in pounds)
Please answer the following questions to the best of your ability. If you don't know the date of a vaccination or test, simply say "unsure" or "don't know" Does the dog have: (Select all that apply)
If you checked any of the above boxes, OR if your dog has a medical issue that is not listed, please explain.
Date of last DHLP vaccination and expiration date
Date of Last Rabies Vaccination and Expiration Date
Date of last Bordatella vaccination and expiration date
Date of last Lyme Vaccination and expiration date. If you are updating vaccines prior to surrender, please DO NOT give the lyme vaccine. We do not recommend it for this breed.
Date of last HeartWorm test
Date given and type of Heartworm Preventative (HeartGard, Ivermectin, Trifexis etc.)
Date Flea/Tick preventative last applied and type (K9 Advantix, Trifexis, Frontline etc.)
Date of Last fecal exam for worms and Date/Type of worming (if applicable)
Veterinarian's Name:
Veterinarian's Telephone Number
Number of people in your household
Ages of Children living in the household
Do you currently own other dogs?
If you have other dogs, please list: Breed, Age, Sex, and whether spayed or neutered
Do you currently own other pets? (cats, guinea pigs, birds, etc.) If so, please indicate type of animal, age, sex, and if spayed or neutered
How long are you able to hold the dog you want to surrender?
Will you help transport the dog?
I agree to an online Behavioral Assessment by a qualified behaviorist as a prerequisite to surrendering this dog.
Please acknowledge and initial below: The answers supplied are true to the best of my knowledge
Submission of this form is not a transfer of ownership nor a contract between NGPR & I. Submission of this form does not imply a guarantee that NGPR will accept my dog.
I understand that I must email a picture of my dog to info@nationalpyr.org or text a photo to 518-610-1338 for this application to be considered by NGPR. Please include your name and the name of the dog with any photo submissions.
If NGPR agrees to accept a Transfer of Ownership from you to take possession of your dog for re-homing,
As part of the evaluation for accepting your dog, we will contact your listed veterinarian. I hearby provide authorization to release veterinary information and medical records regarding my pets to representatives of National Great Pyrenees Rescue. (please initial)
By submission of this information, and my(our) initials in the following box, I(we) attest that I currently have ownership of this dog, have made a serious effort to find the owner of the dog if he/she is a stray and that the information provided on this application is true and accurate to the best of my(our) knowledge. I(We) understand that completion and submission of this form does not constitute a transfer of ownership nor that National Great Pyrenees will accept my(our)dog. Should NGPR decide to accept this dog, I (we) agree that upon written notice of acceptance into the program, that I(we) will work with the rescue in good faith.*
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