Let Us Help You to Keep Your Pet During Tough Financial Times!
Your Main Email Address (enter only one valid email address):
Enter alternate email addresses here:
Your First Name:
Your Last Name:
Your City and State?
Name of Bichon/BichonMix in need of rescue:
Is this dog a Bichon or Bichon Mix?
Sex of dog:
How much does this dog weigh?
Where did you originally get this Bichon?
Has this dog been Spayed or Neutered?
Can you tell us why this dogs needs to be rehomed?
Your phone number and the best times to reach you?
Your relationship to the dog?
Relative of Owner
Friend of Owner
Found the dog
Has this dog ever bitten?
If yes, how many times?
Have you sought out help from your vet or behaviorist about this problem?
Is this Bichon good with children?
Vet's Phone Number
I give permission for SPR to contact my veterinarian and to get a copy of my dog's vet records. (Please enter your initials and date your yes answer.)
Tell us a little about this Bichon's health:
A picture of your dog is needed before we can accept he/she into rescue. Please e-mail a picture immediately after submitting this form to firstname.lastname@example.org
. If you can't send a picture, we will need to call your vet to verify that your dog is a Bichon or a Bichon mix.
Yes I will send a picture
Call my vet at
I understand that after surrender, my Bichon may be flown via the commercial airlines to their new foster/adoptive home in another part of the country.
Initial and date:
Is this Bichon or Bichon Mix safe for the time being?
Indicates Response Required