This form allows you to register your Chesapeake Bay Retriever so that he or she can be listed on the Adoption Options pages.  It is imperative that you inform us as soon as the dog is placed so that we can remove him or her from the listing of available dogs.

All dogs listed on Adoption Options must be spayed or neutered prior to being listed. This will prevent your pet from becoming breeding stock at a puppy mill. That is a horrible existence that we do not want any dog to have to experience. If you can not afford to spay or neuter your pet, there are many low cost spay/neuter programs that may be able to help.

Please fill out this form as completely as you can.  The more information (and pictures) you provide, the better your chances are that someone will respond to your listing and show interest in providing a new home for your dog.  Don't worry if you don't know all of the answers to the questions asked below - just fill in as much as you can.

In addition, you will receive more responses if you can send us a photo of the dog. You may send it via email (.BMP, .JPG, or .GIF format please) to ao_admin@cbrrescue.org

Adoption Option Classification
This dog is being listed as:
Physical Description of the Dog
Name of the dog :
Approximate age of the dog in years:
What is the color of the dog?
What is the sex of the dog? Male     Female
Approximate weight of the dog:

Medical History
Has the dog been spayed/neutered? Yes   No
Which vaccines has the dog received?
Rabies
DHLPP
Kennel Cough
Heartworm preventative
Flea pill
Dewormed
Is the dog heartworm negative? Yes  No Unknown
Any other special health concerns or conditions, including medications:
Behavior
Is the dog housetrained? Yes  No  Somewhat
Reason the dog was placed in rescue:
Please specify if "other"
The dog is good with
Other Dogs
Strangers
Cats
Children
The dog likes
Water
Retrieving
Hunting
Car Rides
Working ability of the dog?
Excellent
Good
Fair
Poor
Unknown/untested
Comments about working abilities and extent of training/exposure
Behavioral Problems:
Jumps fences
Digging
Chewing furniture/other items
Submissive urination
Chasing/nipping
Excessive barking
Dominance over humans
Separation Anxiety
Other
If "Other" please specify:
Has this dog ever bitten anyone? Yes No
If yes, would you please explain the situation(s) that occurred around the bite(s)?
The dog knows the following commands (or some variation):
Sit
Stay
Down
Come
Heel
Bathroom Command
Tricks and other commands
Other Information
Please enter any other information that you think is important to know about this dog:
Owner Placement Information (If this is an Owner Placement, please fill out the section below.)
Name of person to contact about adopting the dog:
Phone number:
Email address:
City and state where the dog is currently located:
Shelter Information (If this is a Shelter Dog, please fill out the section below.)
Shelter Name:
Shelter Phone Number: 
Shelter Email:
Shelter Contact Person (if applicable):
Shelter Location - City: State:
Shelter Dog ID#: