In order to properly place and/or advertise on our website an Icelandic Sheepdog that is in need of a new home, the ISAA
must first have a written evaluation of the dog by a professional sent to ISAA Rescue. Whereby it is our intent to do
everything possible to place your dog, severe behavioral problems or pre-determined health issues may keep us from
finding a proper home. We ask you to complete the following questionnaire with full disclosure of any behavioral or
physical issues the dog may have.
Dog’s Formal Name and Sex: __________________________________ Male Female
Dog’s Call Name: __________________________________
Breeder: __________________________________________
State and /or Country of Origin: _______________________
Registration #:______________________________________
Dog’s date of birth: _________________________________
1. What is the reason for the placement of your dog?
_____________________________________________________________________________________________
______________________________________________________________
2. Has your dog been bred or used as a stud? Yes No (please circle)
3. How long have you had this ISD? _________________
4. Are there any other animals in your home? Yes No (please circle)
5. If yes, please list other animals along with their breed, age and sex.
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6. Have you observed any aggression in your dog? Yes No (please circle)
7. Please explain what type of aggression:
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______________________________
8. Has your dog bitten people? Yes No (please circle)
9. What were the circumstances behind this and was any type of medical attention needed?
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10. Does your dog get along with other animals? Yes No (please circle)
11. Have you had your dog trained by a professional trainer? Yes No (please circle)
12. Has your dog been de-barked? Yes No (please circle) How many times? ______________
13. When were the dogs’ last inoculations? Month/Day/Year _____________________________
14. What medication does your dog take? (please include flea, heartworm preventative, behavior etc.)
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15. For how long has he taken this medicine? __________________________________________
16. Does your dog travel well? Yes No (please circle)
17. What mode of transportation has your dog been transported? Car ______ , Plane ______, Bus ______, Other
_____________________________________________________________
18. Is your dog crate trained? Yes No (please circle)
19. Does your dog become more aggressive in a crate? Yes No (please circle)
20. What do you feed your dog? (please list brand and type of food)_________________________
21. Do you give your dog table food? Yes No (please circle)
22. How does your dog typically greet a stranger? (please explain)__________________________
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23. Does your dog like to be groomed? Yes No (please explain)
24. Does your dog become aggressive when you clip his/her nails?
25. If you have multiple animals, do you feed them together? Yes No (please circle)
26. How much exercise does your dog get?
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27. Has your dog ever been injured? Yes No (please circle)
28. What were the circumstances behind the injury?
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29. Please list any surgical procedures your dog has had:
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30. Has your dog been diagnosed with any inherited health issues? ( eyes, hips, etc.)
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31. Please share the living environment of your dog: (apartment, house, farm, city, etc.)________
______________________________________________________________________________________________
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32. Has your dog damaged your home or living arrangements? Yes No (please circle)
33. Please explain:
______________________________________________________________________________________________
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__________________________________________
34. Is this dog registered or recorded with any organization of kennel club? Yes No (please circle)
35. Do you have a pedigree for this dog? Yes No (please circle) If so, please attach a copy
36. If you are away over night, where does your dog stay?
______________________________________________________________________________________________
____________________________________________________________________
37. Is anyone in your home allergic to dogs? Yes No (please circle)
38. How well does your dog get along with the following:
Adult Family Members? Excellent - Good - Fair - Poor (choose one)
Children living at home? Excellent - Good - Fair - Poor (choose one)
Strangers? Excellent - Good - Fair - Poor (choose one)
Other dogs? Excellent - Good - Fair - Poor (choose one)
Other animals? Excellent - Good - Fair - Poor (choose one)
Please comment if necessary ________________________________________________________
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39. Have you had dogs before? Yes No (please circle)
40. If yes, what breeds?
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41. Have you ever relinquished a dog before? Yes No (please circle)
42. If yes, what were the circumstances?
______________________________________________________________________________________________
______________________________________________________________________________________________
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43. Is your dog housebroken? Yes No (please circle)
Reference
Who is your Veterinarian? Name ___________________________________________
Address__________________________________________
City, State Zip____________________________________
The Icelandic Sheepdog Association of America is not liable for any dog placed through our rescue organization. This
questionnaire is simply to help ascertain the best possible placement of your dog. By signing this questionnaire, you have
stated that to the best of your ability all answers are true statements of the current conditions of your dog.
Signature: ___________________________________________________
Date: ________________
**The ISAA requests a $100 donation to the Rescue Fund and a current photo of your dog to accompany this application.
Additional Expenses:
Transportation Expenses: All transfer expenses shall be paid for by relinquishing
party. (Air, Gas and Mileage, as needed)
General Treatment Expenses: Any known treatment needed should be taken care of
before dog is relinquished. However, ISAA will pay for
but not limited to a veterinarians exam, rabies vaccine,
and heartworm if the dog is being abandoned on a case
by case basis.
Evaluation Expenses: Mandatory – written evaluation is to be submitted to ISAA
before further processing can continue.
This cost could be as little as $50 or as high as $500. Please
be certain you seek a respected professional in the field of
pet behavior. Check with your veterinarian or animal shelter.
Food: Any donation to foster home is appreciated
Form received by: _________________________________
Date received: __________________________
Dog placed in Foster Home of: _______________________
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Dog placed in Permanent Home of: ________________________
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Application for ISAA Re-homing