allow lhasa happy homes rescue

8/14/2019 Allow Lhasa Happy Homes Rescue

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1158 26TH Street, Santa Monica, CA90403310.74-LHASA 310.745.1551 [email protected] OF ALL CLAIMS

I hereby release to LHASA HAPPY HOMES RESCUE, this pet as described herein:

Dogs name____Belle_______ Age ____5_______ Birthdate (if known) ____June 6___MaleFemale

Weight ____19__ Color____White___Breed _________Lhasa Apso________Spay/Neutered ______2003_____(date)Reason(s)you are giving up: ____Do not have the funds or time to car for her___________________________________

DOG INFO: Housebroken OK/dogs OK/Cats Good w/ kids Gives KissesProtective*Snappy* Food Aggressive Separation AnxietyDestructive/chews* Plays w/ toys Barker*

Uses Doggie Door Ok Alone during Day Knows Commands* Good in the car Good on Leash

*Please explain Protective and barker-Lhasas were bred to be alarm/guard dogs by barking at strangers ergo she barks

Commands she knows how to sit, stay, come, kiss, _____________________________________________________

Ever bitten anyone/drawn blood/stitches? Explain (please provide dates and circumstances) _____________________

_______________________________________________________________________________________________

Dog came from Friend Breeder Rescue Pet Store* *Have you contacted original breeder or rescue to let

them know dog needs to be rehomed? Yes No If not, why not? In Georiga__________________________

*Name of Pet Store purchased from ________________________________ Phone # ___________________________

Flea Control: Yes No Type:Frontline Advantage Revolution Last Given (date)_12/08__________

Shots Up to Date? Date Last rabies __10/08_____ DHLPP __10/08_______ Bordatella __10/08_________

Any special needs? Phenobarbital ___________________________________________________________

Has the dog received obedience training? Yes No Explain: ______________________________________

Brand of food? Pedigree____________Wet Dry Feeding Time(s)/Amt Any______________________

Presently sleeps in Own Bed Human Bed Outside Other: _______________________________________

Is he/she microchipped? Yes No Avid Home Again Other # ___________________________

Any medical issues/on any medication: (Allergies, health history, etc) Phenobarbital b/d of epilepsy______________

________________________________________________________________________________________________

Best/Worst characteristics of your dog (including any attitude): Extremely loving and great happy demeanor, needs lots of love!

__________________________________________________________________________________________________________


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1158 26TH Street, Santa Monica, CA90403310.74-LHASA 310.745.1551 [email protected] YOU CAN TELL US ABOUT YOUR DOG THAT WILL HELP US IN REHOMING:

She is perfect we cannot care for her b/c of 2 new babies and the time and money it takes to care for them____________________

__________________________________________________________________________________________________

What will you be sending along with the dog (food, bed, toys, crate, etc)? Crate, toys_________

__________________________________________________________________________________________________

Donation to Lhasa Happy Homes for spay/neuter/placement/shots/fostering: $____________

Upon my release of the above-mentioned pet, I agree to allowLhasa Happy Homes Rescue (LHH) select a new home for this animal,

which they deem to be appropriate, without any involvement from me (as the former pet owner), unless agreed upon in advance. Bysigning this document, I, being of lawful age, do hereby release, acquit and forever discharge LHH and their employees, agents(hereinafter collectively designated as the releasees) of and from any and all allocations, causes of action, claims, demands on account

of or in any way growing out of any and all claims of any kind resulting, or to the result from, or by reason of the conduct of releasees

occurring at either any time prior hereto or hereinafter.

Further, by signing this document below, Lhasa Happy Homes certifies that it will foster and care for your dog(s) until such time asthey are re-homed with a permanent family. We will house and board, vet and medicate, spay/neuter if necessary, groom, de-wormand provide a loving environment for your pet. We will not, under any circumstances, resell your animal for the purposes of medical

research or anything related thereof.

DOGS NAME: BELLE____________________

Agreed to and accepted by____________________________________on this________day of____________, 2006. Name Please Print Date Month

_______________________________________________ Email Address: _______________________________Pet Owner (Releaser) Signature

________________________________________________ Phone: _____________________________________Address

__________________________________________________________

City/State Zip

VETERINARIAN: __________________________________________(name)

______________________________________________________(Clinic)

PHONE___________________________________________

IMPORTANT: Please attach copies of current shot records, sterility and rabies certificates and send along with a

signed copy of this Owner Release Form (OTI). Thank you.


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allow lhasa happy homes rescue

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