Volunteer Submitting Form:

Date of call:

Follow-Up Questions:

Current address and Phone # (if different from contract)

Dog's name and NERR&R ID#:

Is your NERR&R dog still living and in your possession? Yes No
If No, where is your NERR&R adopted Rottweiler?

Are you and your dog currently enrolled in a 6-8 Week obedience course?
Note: If you are currently enrolled, please remember to mail a copy of your certificate of completion to PO Box 510, Portsmouth, RI 02871 as specified on your contract.

We have completed our obedience class.
Where did you attend?
When did you complete?

Yes, we are currently enrolled.

No, we are not currently enrolled.

If you are not currently enrolled, please tell us when you plan to enroll:

Is your NERR&R dog currently licensed, vaccinated and had heartworm and fecal check this year? Yes No
Dog's license number and the city/town it's licensed with:
Note: As part of our adoption contract you are required to send in a copy of your dog's license. Please do so now if you have not already done so: PO Box 510, Portsmouth, RI 02871.


The date of the last vet visit Vet's name and number:
Rabies tag#:

Are you satisfied with your NERR&R dog as a family member?
Completely We're getting there Marginally Not at all

Are there any concerns you have regarding your NERR&R dog?

Has your NERR&R dog ever bitten a person? Yes No
If yes, please explain the incident (optional):

Are you satisfied with the services you have received from NERR&R?
Completely We're getting there Marginally Dissatisfield

What could NERR&R do to improve its services?

Do you check our website regularly? Yes No

Do you read our newsletter? Yes No

Tell us what remarkable improvements or achievements your NERR&R dog has accomplished.

Would they like the Adoptions Follow-Up Coordinator or member of the Education Team to follow up with them on their comments?
Yes No

Phone # and time to reach them or e-mail address:

Volunteer Comments.