Information on Labrador for Rescue

Labrador UK Action Group (LUKAG)
Church Lane, Thwaite, Eye, Suffolk, IP23 7EJ
Information on Labrador for Rescue
Insert a photograph of your Labrador*

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Labrador's Name?*
Date of Birth? *

DayMonthYear
Date
Is your Labrador a "Cross"?
If so, what breed is it crossed with
Gender?*
Colour*
Age*
Microchip Number*
Is the microchip registered to you?
If not, please give registered owner details
Is your Lab KC Registered
Is your Lab -
If intact Female, date of last season -
If intact Female, has she ever had a litter of puppies?
Give dates and more information

Owner(s) Name*

TitleFirst NameLast Name
Owner(s) Name

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Mobile or Landline Number*

Area CodePhone Number
Email*
example@example.co.uk

Vet Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Date of last visit to the Vet?*

DayMonthYear
Date
Is your Lab up to date with Vaccinations?*
Date of last vaccination
Is your Lab up to date with Flea Treatment and Worming?
Date of last treatment
Has your Lab been given a kennel cough live vaccine?
Date of vaccination
Do you have vaccination documentation?
If not, we will need to contact your vet to obtain this information.
Does your Lab have any health problems?*
including allergies
Does your Lab need any medical treatment prior to re-homing?*
I am happy for you to contact my Vet, named above to obtain full medical history on my Labrador named below. Please sign (using an input device) in the box below to give authority.*

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Reason for re-homing
What sort of new home would you consider most suitable for your Lab?
What features of the new home would you consider most important?
family; couple, retired, quiet, busy, large garden etc .......
If you would like to make a very kind donation to Labrador UK Action Group, it can be done by

www.paypal.me/LabUKAG
(A Paypal account is not required)

Alternatively, cash can be given in a sealed envelope to our transporter.

Thank you

Now for the legal bit .........
I/We* as the person(s) named above, confirm that I am / we are* the legal owner(s) of the Dog named and identified above and that I/We* have requested that Labrador UK Action Group assist me/us* to rehome the dog named and identified above. I/We* hereby authorise the release and disclosure, verbally and in writing, of all veterinary history, records and health information regarding the above named dog.

I/We* confirm that it has been fully explained to me / us*, that all veterinary history, records and health information relating to the above named dog are required by Labrador UK Action Group in order to ensure the continuing welfare of the Dog and the safety of any member of staff at LUKAG or rescue, future adopters and third parties.

It has been fully explained to me / us* that when the dog is collected I / We* will be required to sign a Change of Ownership Form (Relinquish Form)

I / We* understand that the Change of Ownership Form is also a legal binding document which will relinquish all my / our* rights to the above named dog on handover.
The information that I have given above is a true and accurate record of my Labrador. I have not witheld ANY information which may have consequences to any future home.

OWNER(S)
Signature (1)*

Clear
Signature (2)

Clear
Witness (on Collection)

Clear
How we will use your information:

We will use the information you have provided in this form and on our Notice of Intent Form for us to help you rehome your Labrador in accordance with the General Data Protection Regulation 2018. We will check and/or share this information, where necessary, with the nominated rescue, our home to rescue (or foster) transport team, to process the rehoming of your dog(s). We will not share your information with anybody else.

I confirm that I understand and agree to give my consent for my personal details to be given to LUKAG
Should be Empty:

Labrador UK Action Group (LUKAG)Church Lane, Thwaite, Eye, Suffolk, IP23 7EJ

Information on Labrador for Rescue

Labrador UK Action Group (LUKAG)
Church Lane, Thwaite, Eye, Suffolk, IP23 7EJ