Dog Intake Form

Give us the scoop on the new dog!

Entries with a red * are required.

Dog's Name *

Date Acquired *

Breed *

FRR ID Number *

Microchip Number *

Age of Dog *

Dog's Date of Birth (if known)

Gender of Dog *FemaleSpayed FemaleMaleNeutered Male

Origin of dog *ShelterOwner Turn-InAnother RescueBorn in Rescue

Shelter Name *

Impound Number *

OTI Name of Owner *

City *

Name of Another Rescue *

City *

FRR Name of Mother Dog *

Health Concerns *

Known Behavior History (friendly with kids/cats/dogs, hand shy, resource guarder, etc.) *

Intake Volunteer *

Approved By *

Dog’s Rep *

Submit