Thank you for for looking out for the Cocker in your care by turning to San Diego Spaniel Rescue for assistance. Our primary goal is to help you learn about the breed and offer suggestions so that you may keep your Spaniel as a member of your family. We do understand that you may be faced with a situation where you just can't keep your dog with you.

We appreciate you taking the time to fill out this form.
This is our first chance to begin to learn about your Spaniel and to know the best way to help you. Please be as honest as you can with all the answers. We will be following up with you in 24 - 48 hours after receiving this form in our email. San Diego Spaniel Rescue is run entirely by volunteers and we thank you for your patience!

E-mail Address: *
Dogs Name *
Dogs Age *
Dogs Breed *
Dogs Color *
Dogs Sex *
Spayed/Neutered? *
Vet’s name and phone number? *
Last Rabies Shot? *
Last Vax? *
Last Heartworm Test? *
Heartworm positive or negative? *
On Heartworm Preventative? *
On Flea/Tick Preventative? *
Date of last Grooming/Bath?
How long has owner had dog? *
Where was dog acquired (breeder, shelter, rescue, pet store, etc)? *
Name of above (breeder, shelter, rescue, pet store, etc?) *
Location of dog now (city/state)? *
Reason for giving up? *
Temperament? Specifically - how is dog with: women? men? children under 10? other dogs? cats? birds? *
Has this dog ever bitten/nipped? *
If so, what were the circumstances?
Is the dog crate trained? *
Is the dog housebroken? *
Where has the dog been kept during the day (indoors/outdoors)? *
Where has the dog been kept during the night (indoors/outdoors)? *
Does the dog ride in a car? *
(if yes, in what fashion: loose? crated? Seat belted?)
How does the dog walk on a leash (trained to heel? pulls? etc)?
Level of obedience? *
Any current medical conditions? *
Any other info? *
Is a picture of the dog available?
When was the photo taken?
Name of Legal Owner?
Contact info for San Diego Spaniel Rescue (your name, phone, address, etc)? *

* Required