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Canine Surrender Questionnaire

  1. Kenton County Animal Services Logo
  2. Canine Surrender Questionnaire

    No one knows and loves your dog the way you do! In order to find the most appropriate home for your dog, please complete the following form.    

    Please note: Submitting this questionnaire online is NOT a confirmation of an appointment. To schedule an appointment to surrender an animal, please call the shelter during business hours at (859) 356-7400 to speak with a staff member.

  3. Sex:*
  4. Relationship to dog:*
  5. Spayed/Neutered?*
  6. Microchipped?*
  7. Up-to-date on vaccinations?*
  8. Do you have the paperwork?*
  9. Is your dog currently on any medications?*
  10. Has your pet ever been involved in a bite incident?*

    A bite incident is qualified by any incident where an animals' tooth or teeth break skin on a human or other animal.

  11. Is the dog housebroken?*
  12. Is the dog crate trained?*
  13. Does the dog do well in the car?*
  14. Has the dog lived with:*
  15. Is the dog protective or may bite over any of the following with humans?*

    Check all that apply

  16. Is the dog protective or may bite over any of the following with other animals?

    Check all that apply

  17. When left alone, does the dog ever show any of the following behaviors?*
  18. Is the dog an escape artist (climbing fences, escaping crates, etc.)?*
  19. Check all of the following that describe your dog:*
  20. Leave This Blank:

  21. This field is not part of the form submission.

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