Please fill out for EACH dog or cat being transported
Dog(s) or Cat(s):
Name:
Breed:
Sex:
Spayed/Neutered (must be s/n for transport to adopter):
Age:
Weight:
UTD on age appropriate shots:
Rabies tag (must have tag or original certificate for transport if old enough):
Health Certificate obtained:
(this is NOT the same as a shot record, but a Dept of Ag form that a vet must fill out after examining your animal for transport across state lines to be legal)
Treated for fleas/ticks (please make sure animals are parasite free):
Temperment:
Ok with other dogs:
Special needs:
Crate provided by sending:
Dimensions of crate (LxWxH):
(all cats must be sent in a crate with room to move about and a small litter box)
(all young puppies must be sent with their own crates and plenty of pee pads as they will not be walked)
All dogs that will be walked must be wearing a martingale collar or harness with the receiving's phone # on it and be sent with their own leash. Does sending agree to provide:
Other items provided:
Does dog ride well in car:
Other information:
Reason for transport:
Photo of passenger attached:
Sending Party
Name of sending party:
Physical address:
City, St, Zip:
Business phone:
Cell phone:
Can you receive text messages?
Email address:
Do you have email access after 5 and on weekends?
Is sending doing first leg of transport?
Please provide if different from above
Name of driver:
Driver's address:
Driver's cell phone:
Driver's email address:
Driver's vehicle desc:
Is sending a shelter or boarding facility?
If so, what are your hours?
Is sending a rescue?
If so, do you do home checks before adoption?
Do you spay or neuter before adoptions?
In what manner have you screened the receiving party?
Receiving Party
Name of receiving party:
Physical address:
City, St, Zip:
Home phone:
Cell phone:
Can you receive text messages?
Email address:
Do you have email access after 5 pm and on weekends?
Distance willing to drive (must do at least the last leg):
Please provide if different from above
Name of driver:
Driver's address:
Driver's cell phone:
Driver's email address:
Driver's vehicle desc:
Is receiver an adopter?
If so, has a home check been done (this must be completed before transport):
Vet reference:
Personal reference with email address and phone number:
Transport coordinator reference if you have used one in the past:
Attach a copy of your adoption application