GRRA - Welcome to Golden Retriever Rescue of Atlanta

Intake Form

Thank you for choosing to place your retriever with GRRA™, please provide us with the following information.There are no "right" or "wrong" answers to these questions. The answers help us make decisions on which foster homes your retriever can go to.

Shelters, Vets and Finders of Strays: please provide as much information as you know.

Owners: please answer all questions. Failure to provide information requires a follow-up phone-call. We cannot place your retriever on our intake priority list until we have all appropriate information.

What is your Retriever's
Name:
Age:
Gender:
Color:
Breed:
How did you obtain the dog?:

Is your retriever
Good with other dogs?:
Good with cats?:
Good with kids?:
Housebroken?:
Spayed or Neutered?:
Current on Shots?:
Thunder phobic?:

What Heartworm Treatment is your retriever taking?:
Are there other Medical Issues we should be aware of?:
Are there Behavior or Other Issues we should be aware of?:
Has this retriever ever bitten anyone?:
What is your reason for giving up this retriever?:

Placement Contact Information
What is your name?:
In what town or city do you live?:
What is your phone number?:
Please provide a secondary phone number, if available:
Please provide an email address where we can contact you:

For GRRA™ Use Only: