Rescue Corgi Questionnaire

Please look over this form, enter the information, and then press the 'Submit Form' button at the bottom of the page. This form will be automatically sent to the PWCCSC Corgi Rescue contact.

If you want to clear all the form's information and start over, press the 'Reset Form' button at bottom of page, re-enter the information, and press the 'Submit Form' button. This form will then be sent to the PWCCSC Corgi Rescue contact.

Finally, if you want to quit this form altogether, click HERE or on the 'Return To Corgi Rescue' page link at the bottom of this page. Nothing will be sent.

Date:

Your Name:

Corgi's Name:

Street Address:

City: State: Zip Code:

Phone: Home: Phone: Work:

Cell Phone:

Email Address 1: Email Address 2 :

Corgi's Gender:

Corgi's Date of Birth :

Color:

Weight:

Does Corgi have a tail ?:

Is Corgi Neutered/Spayed ?:

Are Corgis vaccinations current ?:

Is Corgi micro chipped ?:

Please describe the corgi's general health:

Name and phone number of veterinarian:

Please describe the Corgi's personality:

Please describe the Corgi's behavior with children:

Please describe the Corgi's behavior with other animals(dogs, cats, others):

Please describe any aggressive tendencies:

Please describe the Corgi's favorite toys :

Is the Corgi housetrained ?:

Has the Corgi had Companion Obedience training ?:

Please describe where the Corgi sleeps :

Please describe how this Corgi was acquired :

Please describe why does the Corgi need a new home ?:

Is there any other information or history we should know about ?:

- Or, If you don't want to complete this form now, you can -
Click Here to Stop Now and Return to Rescue Page

Rescue Corgi Questionnaire

PWCCSC Copyright © 2002 [PWCCSC]. All rights reserved. Revised: July 18, 2005

PWCCSC
Copyright © 2002 [PWCCSC]. All rights reserved.
Revised: July 18, 2005