Your Name: *

Phone Number: *

Email Address: *

Physical Address: *

Main intersection: *

City: *

State: *

Zip Code: *

Where did this boxer come from?:

Surrender Reason:

Dog's Name:

Gender: None Selected Male Neutered Male Female Spayed Female

Age (DOB if known):

Weight (approximate):

Color: None Selected Fawn Brindle White

Compatible with Large Dogs: None Selected Yes No

Compatible with Small Dogs: None Selected Yes No

Compatible with Male Dogs: None Selected Yes No

Compatible with Female Dogs: None Selected Yes No

Compatible with Cats or Rabbits: None Selected Yes No

Compatible with Squirrels or Birds: None Selected Yes No

Compatible with Livestock: None Selected Yes No

Compatible with Men: None Selected Yes No

Compatible with Women: None Selected Yes No

Compatible with Infants: None Selected Yes No

Compatible with Toddlers: None Selected Yes No

Compatible with Children: None Selected Yes No

Compatible with Teens: None Selected Yes No

Level of House Training:

Crate:

Car rides:

Has this boxer had obedience classes?: None Selected Yes No

This boxer MUST have:

This boxer must NOT have:

This boxer sleeps where:

How is the dog accomodated when left alone without human supervision?:

Date of Spay/Neuter Surgery:

Date of Rabies Vaccine:

Vet office that gave Rabies shot:

Date of multi-pack vaccination (i.e. 5-in-1 or DA2PPv:

Date of Bordatella:

Date of Wormer:

Brand of Wormer:

Date of microchip:

Microchip manufacturer:

Date of Heartworm test:

Vet that did Heartworm Test:

Heartworm test result? None Selected Yes No

Heartworm Preventative date last given:

Would this boxer be safe without a fence? None Selected Yes No

Any history, issues, or concerns you need to pass along:

Final notes:

Upload Photo: *
Max. upload photo size is less than 1MB