Silky Terrier Club of America

Rescued Dog Record ~ Intake

Name of Person Completing this form:

Rescue Date:

Silky's Name:

Silky's Age:

Location of Rescue (state):

Rescued From?:
Owner Turn In
Shelter
Stray
Other

If Rescued From - Other, Specify:

tommy from iowa

Silky's Gender:
Male, Intact
Male, Neutered
Female, Intact
Female, Spayed

Reason in Rescue (check all that apply):
Owner ill or deceased
Stray
Behavior Problem
Housetraining Problem
Doesn't like kids
Aggressive
Doesn't get along with other dogs
Other

If Other Reason in Rescue, Specify:

Comments or Notes:

matilda