Dog is Pending

Use this form to notify the BRAT Administrators that a dog's placement is pending.

Dog Name
Please check one Dog is a Basenji   Dog is a mix
What state was the dog rescued from?
Is the dog listed on BRAT's Web site? Yes   No
If so, in which state?
In which home does the dog currently live? Owner   Foster   Foster-to-Adopt
Coordinator Name
Coordinator E-mail (required)
Adopter Name
Adopter State
Adopter E-mail (required)
Contract Sent? Yes  No
New Dog "Do/Don't" Sent? Yes  No
BRAT Evaluated the Dog? Yes  No
Fanconi Test Results Positive  Negative  Unknown
Heartworm Test Results Positive  Negative  Unknown
Vaccinations
 (check all that have been given)		 Corona  Bordetella  DHLPP  Giardia
 Lyme Disease  Rabies  No vaccines given
Comments 
The new owner may need support because 
(check all that apply)		 Multiple Dogs  Housetraining  Cats  Dominance
 Health Issues  Crate Fear  Separation Anxiety
Comments
Should dog remain on Web site pending the placement?