WILD Canine Rescue
Mailing Address:
3309 Robbins Rd #109,
Springfield, IL 62704
Telephone: (217) 652-5505
Email: wildcaninerescue@gmail.com
www.wildcaninerescue.org

Application for Assistance for Home to Home Program
Our Home to Home Program works with families and individuals in crisis to keep their pets.  We help victims of domestic violence , hospitalized patients without options, and other emergency situations with foster homes, temporary boarding, and other assistance.  

Our Home to Home Program will help owners rehome their pet. Re-homing may be the best option sometimes. Though it’s difficult to accept, don’t delay after coming to this conclusion. You’ll want to find your companion a new home and keep them out of the shelter. Let us help.

Here are some signs that it may be time to find a new home for your pet include:
1. You are concerned for the safety of your family and you don't have the time or money to work with the pet and trainer to resolve.
2. The environment does not meet your dogs needs
3. You can no longer afford to provide the dog with proper care
4. Your health is being compromised

The Home to Home Program will keep dogs out of the shelter and prevent healthy dogs from being euthanized.
Your Information
First Name *
Last Name *
Email Address *
Street Address: *
Address Line 2: (if needed)
City: *
State: *
Zip: *
Primary Telephone: *
Your Dog(s)
Dog's Name(s): list all here *
Age(s): *
Breed(s): *
Male/Female and Spayed/Neutered (please describe sex and if altered below): *
Up to date on shots *
Veterinarian's Name *
Has this dog ever bitten anybody? *
Your Situation
Are you need temporary assistance to keep you and your pet together? *
If you answered yes above, please explain how WILD Canine Rescue and its volunteers might be able to help you keep you and your pet together?
If you answered yes above for temporary assistance, please explain the reason for your need:
If you answered no to temporary assistance, it must mean you are looking for assistance from WILD Canine Rescue to help you rehome your dog. Is this correct?
Clear selection
If this is correct, please give us more information why you are needing to rehome your dog? WILD is 100% foster based, therefore we will ask that you keep your dog(s) in your home until we can find a new approved home for them. We ask that you provide AT LEAST 30 days to assist before surrendering your dog(s). *
Provide a summary bio answering these questions: good with kids, cats, dogs; potty trained, crate trained, leash trained; does this dog need a fenced in yard? Does this dog need extra medical care? Where does the dog sleep, and where does the dog go when you are not home? *
EMAIL PHOTOS TO WILDCANINERESCUE@GMAIL.COM Provide Picture(s) of your dog(s): please use images of their face, sitting, standing, and NOTHING in the background - pictures make a big difference in capturing someone looking to adopt!
By completely this form, and asking for WILD Canine Rescue's help in rehoming my dog(s), I understand that the images I provide will be posted on social medias to advertise rehoming, and once a home is found, I give up ownership and surrender my dog(s) to WILD Canine Rescue. *
Required
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