Surrender Intake Form – part 3 of 4

This page is for medical information regarding your dog.   Please provide as much detail as possible.  A medical condition does not preclude a dog from being surrendered to ECGRR, but not telling us of a known medical condition complicates the situation and does not help us in caring for dogs we take in.

Items marked with a * are required and must be filled in before proceeding to the next page.

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