About Us

Surrender Your Dane

Complete this form to request your dog to be placed into rescue.

Please note that our area includes MI, OH, IN, IL, AL and Ontario, Canada. If you are out of our area, please contact a local rescue.

GDR Inc's coverage area includes Michigan, Ontario, parts of Wisconsin, Illinois, Indiana, parts of Ohio, parts of Kentucky, Alabama and parts of Georgia. If you are not in our local coverage area, please visit the link above to locate your local rescue.
Select your location within our coverage area:
 
Contact information of person submitting request:
Owner Name:
Street Address :
City, State & Zip:
Email:
Work Phone: (Include Area Code)
Home Phone:
Description of Great Dane, hereinafter referred to as "dog"
Registered Name:
AKC Number:
Call Name:
Sex:
Male
Female
Age:
Color:
Please provide the breeder information
Breeder Name:
Organization:
Street Address:
City, State & Zip:
Email:
Work Phone: (Include Area Code)
Home Phone:
Website URL:
Please provide the vet's information
Name:
Street Address:
City, State & Zip:
Email:
Work Phone: (Include Area Code)
Date of current shots: (mm/dd/yy)
Additional information:
Has the dog been tested for heartworms:
 
Yes
No
Unknown
Is the dog on HW preventative:
 
Yes
No
Unknown
Is the dog altered:
Yes
No
Unknown
Has the dog been bred:
Yes
No
Unknown
Is the dog housebroken:
Yes
No
Unknown
Has the dog been obedience trained:
 
Yes
No
Unknown
Is the dog good with children:
 
Yes
No
Unknown
Is the dog good with other dogs:
 
All dogs
Large dogs only
Small dogs only
Males Only
Females Only
Unknown
Is the dog good with small animals such as cats:
 
Yes
No
Unknown
List any known habits the dog has:
 
Does the dog have any preferences to:
 
Men
Women
Unknown
If the dog has ever bitten a person or another animal, please give details below:
 
Does the dog have any known allergies or medical conditions:
 
Reason this dog is dog is being surrendered:
 
Photo Attachment: attach photo (Image file) up to 200kb
 
Colored fields indicate required information.