2024 Mattie's Place Canine Intake Form

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Completing this form helps us to determine if your dog is a fit for our rescue. We can not discuss intake, unless this form is completed.

We can't accept every dog, but we will do our best to assist and will reach out to you if we feel we have suitable foster placement.

Ontario has a massive dog overpopulation crisis currently and there just isn't anywhere for all these dogs to go, including shelters, who are also full and often not accepting dogs.

Email *

Your Name / Address / Phone Number / Email *

Dog Name *

Dog Age *

Dog Breed *

Dog Sex *

Male Not Neutered

Female Not Spayed

Spayed Female

Neutered Male

Required

Dogs Current Weight *

Dogs Veterinary Clinic *

Date of Last Veterinary Exam

YYYY

What food is your dog currently eating?

Is Your Dog Up To Date on Vaccines? *

Yes

Required

Is Your Dog Microchipped? *

Yes

Unknown

Required

How Long Has This Dog Lived With You? *

Where Did You Get This Dog From? *

Why Can You No Longer Keep This Dog? *

Is Your Dog Housetrained? *

Yes

Required

Is Your Dog Crate Trained? *

Yes

Required

How often is your dog exercised and what is the exercise routine? *

How is Your Dog With Kids / Cats / Strangers / Other Dogs? *

Does your dog have any guarding issues with food or toys? *

Has Your Dog Ever Bitten Another Person or Pet? *

Does your dog have any aggression or behaviour concerns *

What Trainer Has Your Dog Worked With? *

Does Your Dog Have Separation Anxiety? *

Yes

Is Your Dog Currently On Medication? *

Does Your Dog Have Any Medical Concerns? *

When Does Your Dog Need To Be Moved By? *

YYYY

What Else Do We Need To Know About Your Dog? *

Please have your veterinarian email us your dogs records: info@mattiesplace.ca. We can not process your intake application without reviewing your dogs records, unless no records exist, as noted above. *

Please email us at least 1 clear photo of your dog: info@mattiesplace.ca (the more photos/videos you send, the better) *

Are you willing to make a surrender contribution if we agree to welcome your dog, and if so, what amount are you able to contribute towards the cost of care for your dog, while at Mattie's Place. *

Would you like us to share your dog with other rescue agencies? (we require you to email us a picture before we can share) *

Yes

Other:

A copy of your responses will be emailed to the address you provided.

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