Apply to rehome your dog - Jerry Green Dog Rescue

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Surrender Information

Choose rehoming location *

Date of Application *

Reason for surrender *

Surrender from owner (personal)
Surrender from owner (financial)
Surrender from owner (behavioural)
Death or ill health of owner
Other

If other, please provide further details *

Save and Resume Later

Dog Details

Dog's name: *

Breed: *

Dog's date of birth: *

How long have you had your dog? *

Vaccinated: *

Yes
No
Not sure

Sex: *

Male
Female

Microchipped: *

Yes
No
Not sure

Neutered: *

Yes
No
Not sure

Has your dog ever displayed signs of aggression to another animal or person? Please provide details if so or write N/A if no. *

How friendly is your dog with children? *

(1- Not at all friendly / 5-Very friendly)

How friendly is your dog with other dogs? *

(1- Not at all friendly / 5-Very friendly)

How friendly is your dog with cats? *

(1- Not at all friendly / 5-Very friendly)

How friendly is your dog with strangers? *

(1- Not at all friendly / 5-Very friendly)

How is your dog cope when left alone? How long for? *

Has your dog ever been in kennels? How did they cope? *

How does your dog respond to handling by owner and by vets? *

Does your dog have any medical problems? *

Save and Resume Later

We offer a blended rehoming approach including Home from Home® rehoming. If we're able to offer support, is your dog able to stay with you until we find him/her a new home? *

Yes
No
Not sure

Owner Details

Name *

First

Last

Phone Number *

Email address *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Additional Information

Where did you hear about us?

Every dog and owner is unique. Please feel free to share any extra details about your situation or your dog’s personality that you think could help us understand your needs better:

Because you care about the work of Jerry Green Dog Rescue, we’ll contact you via post and telephone to keep you updated about the difference your support is making, as well as keeping you up to date with the latest appeals, events and opportunities that may interest you. Would you like to hear from us via email? *

Our Promise: We keep your data secure and confidential in line with our privacy policy. You are in control and can opt out from our communications at any time – you can find the details online at: https://www.jerrygreendogs.org.uk/privacy-policy

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