MidAmerica Boston Terrier Rescue
The following is information, which I, as the rescue agent, have provided to the best of my knowledge.
Pet’s name:
Breed:
Spayed or Neutered date:
Color:
Microchip/tattoo registration (company named/number):
Weight:
Date of birth:
Age:
Gender:
HISTORY
Reason dog was surrendered into rescue:
Date entered into rescue:
Dog’s condition when entered into rescue:
BEHAVIOR
Has the dog ever had a serious fight with another animal?
POTTY
How does the dog tell you he/she needs to go potty?
Has there been any accidents in the house?
What method(s) of discipline do you use when correcting the dog?
Date of last shots…
DHPP: (good for one year)
Rabies:
Rabies tag#:
Rabies Expiration Date:
Vet for Rabies:
Vet for DHPP:
Heartworm test results (+ or -):
Vet for HW test:
What type of heartworm preventative is this dog on?
Date heartworm preventative is given? 30th day of each month
Blood work:
Medical History (shots, illnesses, or accidents, chronic or recurring problems such as ear mites, fleas,
urinary tract infections, etc.)
Allergies:
Medication requirements (temporary or ongoing):
Favorite toys:
SLEEP
Sleeping area:
Crate trained:
Likes/Secure
Vacuum
Fireworks
Thunder
Men
Women
Children
Dislikes/Fear
Timid
Comments…
MidAmerica Boston Terrier Rescue
Strangers
Other animals
Yes
No
Sometimes
No longer
When and Why?
Chews
Nips/Bites
Barks/Growls
Escapes
Climb/jumps fence
Digs
Housebroken
Accidents inside
Enjoys car rides
Crate trained
Snores
Separation anxiety
Aggressive
Timid/Submissive
Confident
Well socialized
FEEDING
Brand of food:
Feeding Schedule, frequency and amount:
List of possessions transferred with the pet:
Crate (bedding items)
Toys
Collar/harness
Heartworm preventative
Medication dog is current on
COMMANDS
Walks well on a leash
Knows….
‘Sit’
‘Lay down’
‘Come’
‘Stay’
‘Kennel Up’
‘Potty’ (refers to pee)
‘No’
‘Good’
YES
YES
X
X
X
NO
NO
MidAmerica Boston Terrier Rescue
Grooming Requirements…
Body
-Does okay in the bathtub. Will become more comfortable in time.
-Do not get water in the ears.
-Only wash the face with water. NO soap.
-Recommend towel drying.
Ears
Use a rolled up tissue. Clean the same days as the bath.
Eyes
Wipe eyes daily with a warm cloth. If eyes ever become red or inflamed see
you vet immediately.
Teeth
Professional teeth cleaning by a vet recommended every 5 to 6 years.
Nails
Does well with nail trimming. Trim nails every two weeks.
Anal Glands
Recommend to be checked once a year.
Collar/harness Clean on the same day as her bath
Bedding
Clean at least every two weeks.
TWICE A Year For Life!
Because pets age so rapidly, major health changes can occur in as little as three months. The risk
of cancer, diabetes, obesity, arthritis, heart disease and other serious conditions all increase with
age. And because today’s pets are living longer than ever, chances are many can experience a
potentially serious illness during their lifetime. TWICE-A-YEAR wellness exams can help your
vet diagnose, treat and even prevent problems before they become life-threatening.
Donation Request: $250.00
(All donations go directly into the rescue fund. We operate as a nonprofit, all-volunteer organization.
Donations are only redeemed for veterinarian care of rescue pets. Rescue agents and volunteers are not
reimbursed monetarily for their time, effort and travel.)