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Buncombe County Animal Shelter: Monday–Friday 10 a.m.–4 p.m., Saturday 12–4 p.m.
Adoption Center: Monday–Saturday 10 a.m.–6 p.m., Sunday 12–4 p.m.
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Owner's Name:
Dog's Name:
Breed
How long have you owned this dog?
Does your dog have any of the following?
Microchip
Spay/Neuter Tattoo
None
Has your dog lived with any of the following:
Other dogs
Cats
Children
This dog lives:
Indoors
Outdoors
Both
Is this dog house/potty trained?
Yes
No
Partially
Does this dog mark its territory inside?
Yes
No
Does this dog repeatedly escape the yard and/or house?
Yes
No
Does this dog excessively bark/howl?
Yes
No
If yes, when does this happen?
What basic commands does this dog know? (Sit, Lay Down, Stay, Come, etc.)
Is this dog leash trained?
Yes
No
Is this dog crate trained?
Yes
No
Does this dog like to play with toys? If yes, what kind of toys?
Does this dog display any type of destructive behavior? If yes, what is this behavior and when does it occur?
Has this dog ever bitten anyone? If yes, please explain in detail.
How does this dog get along with the following populations: Men, Women, Strangers, Babies, Children, Cats, Other Dogs, Livestock.
Has this dog ever required special surgery or medical attention? If yes, please explain:
Is your dog on any special medication? If yes, please explain:
Has your dog been diagnosed with and/or treated for any of the following?
Allergies
Seizures
Urinary Tract Infection
Bladder Stones
Diabetes
Cancer
Deafness
Tumors
Thyroid Disease
Organ Failure
Arthritis
Tick Fever
Valley Fever
Hip Dysplasia
Other
If you answered yes to any of the options above, please explain in detail:
Any other information you would like us to know about this dog:
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