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Placement Assistance Questionnaire

We may be able to help you place this dog provided it looks like a purebred Lab. If your dog is a lab mix please go Here. Our very limited foster spaces are filled with dogs that have come from life threatening situations. We are currently unable to take in any owner surrenders. If your dog meets our requirements of current vaccines/heartworm prevention, is spayed/neutered, and the placement assistance form is filled out in full your dog will be place on our owner referral page for 4 weeks. If you place your dog in a home prior to then please email us and let us know.

To see if your dog qualifies for our program, here is what we will need:

2 pictures emailed to us in jpeg (jpg) format; no larger than 350 pixels or 80 KB, attached to/or inserted into the emailed questionnaire below. (1 picture of the face/head from the front and one whole body picture from the side for each dog submitted.) Please try to get clear pictures of the dog in good light.Copy and paste the following into a new EMAIL (Do NOT send as MS Word Document, PDF Document, Flier, etc. as it will not be processed!), fill out the answers, attach the pictures,and send it to us at . We will post your dog ASAP.

If you do not know how to copy and paste, click Here to open step by step instructions in a new window.

Please be honest and complete in your answers! We realize dogs are not perfect and that if this dog was perfect, you would most likely keep it.

Forms submitted without pictures will not be considered! Please do not fill out this form if the dog has been placed or is currently in a shelter.

Your full name:
Spouse’s or joint owner’s name:
Your address:
City/Town:
Your HOME phone number (Include area code!):
Work or Alternate number (Include area code!):
Your Email address:
How long have you owned this dog?
Is this a purebred lab or a lab mix?
Did you get this dog from a breeder?
If so, breeder's name:
Breeder’s City & State:
If from a breeder, have you contacted the breeder about taking the dog back?
Do you have AKC papers?
If so, what is the full registered name of this dog?
What is the registration number?
If not acquired through the breeder, where did you get the dog?
If dog was acquired through a rescue group or shelter please list name, city, state.
If the dog was/is a "stray" what steps have you taken to locate the owner?
If a stray and you tried to locate the owner, what newspaper did you run a found ad in?
The dates the found ad ran?
Dog’s "Everyday/Common" Name?
Dog’s Age?
What sex is this dog?
Describe the color and/or markings:
Is this dog good with very young children?
Is this dog good with other dogs?
Is this dog good with cats?
Has this dog ever growled at, snapped at, or bitten any human or other dog?
If yes to the above question, please give the full details of what happened:
Has this dog recently lived indoors?
Is this dog housetrained?
When outdoors, does this dog stay:
In a fenced yard?
In a dog lot?
On a chain or runner?
Run loose?
If fenced, what kind of fence and height?
Does this dog jump and/or climb over fencing?
Dig out under fencing?
Has this dog ever had any obedience training?
Is this dog: Spayed/Neutered?
Current on vaccines?
Current on heartworm preventive? Veterinarian’s Clinic Name:
Veterinarian’s Phone Number:
Veterinariany Clinic Address:
Name Vet records are listed under:
If this dog is not spayed/neutered are you willing to have it done?
If not, why?
If this dog is not current on vaccines are you willing to get it current?
If not, why?
List the positive traits/habits this dog has:
List the negative traits/habits this dog has:
Why are you looking for a new home for this dog?
What contact information do you want listed on the web site for potential adopters to use to contact you? (If this question is left unanswered I will list both your home phone number and your email address)

By completing and sending us this form, you are stating that you are the legal owner of this dog, that you are at least 18 years old, that all information you provided is true and correct, and that you agree to have Lab Rescue of NC (LRNC) list your contact information on our web site so that potential adopters can contact you. You agree that LRNC is under no obligation to list this dog as a referral, and that if LRNC does list the dog, LRNC accepts no responsibility/liability for this dog or the placement/adoption thereof.

Your FULL name:
Today's Date:

If you do not hear from us within a few days PLEASE let us know as we may not have received your application!