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Adoption Application
Approval Process
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Pay Your Adoption Fee
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Foster Application
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Why You Should Rescue
How Rescue Works
Choosing the Right Dog for You
Helping Chained or Penned Dogs
Tips For Taking Better Dog Photos
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Home
About
About Us
Why You Should Rescue
Contact Us
Adopt
Available Dogs
Adoption Application
Approval Process
Success Stories
Pay Your Adoption Fee
Donate
Volunteer/Foster
Sign Up
Foster Application
Resources
Why You Should Rescue
How Rescue Works
Choosing the Right Dog for You
Helping Chained or Penned Dogs
Tips For Taking Better Dog Photos
Success Stories
Shop
Worthy Dog Rescue Animal Custody Record
WDR Animal Custody Report
Animal name/ID
*
Custody date
*
Custody time
*
:
HH
MM
AM
PM
Reason for custody
*
Stray/at large/unowned
Owner surrender
Transfer from Virginia releasing agency
Transfer from out-of-state releasing agency
Location where custody was taken
*
Owner's name and address (if known)
Additional information
Animal Description
Species
*
Dog
Cat
Breed
*
Color/markings
*
Sex
*
Male
Female
Approximate age
*
Approximate weight
*
Other animal information
Animal Identification
Check for all forms and complete all boxes. If not found, write "none."
City/county license number
Rabies tag number
Tattoo
Collar (color, type, etc.)
Other identification (microchip, ID tag, etc.)
Disposition of animal
*
Return to owner
Adopted (or in WDR foster care)
Euthanized
Died in custody
Transferred to another Virginia releasing agency
Transferred to out-of-state releasing agency
Name of the releasing agency transferred to
Preparer's Information
Your name
*
Your title
*