Adoption Information
1) How did you hear about us?
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Adopt-a-Pet
Petfinder
Facebook
Internet Search
Advertisement in Paper
Referral From Someone Else
Show/Festival Booth
Other
If other, please indicate
2) What do you know about the breed you are interested in adopting (temperament, health, etc)?
3) Why do you want to adopt this dog? Please give all reasons that apply (companion, guard dog, gift, to breed, personal protection, for children, other).
5) Do you rent or own your current home?
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Own
Rent
4) How long have you lived at the above address?
6) What type of home do you currently live in?
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Single Family Home
Multy-Family Home
Condo
Townhouse
Apartment
Mobile Home
7) If you rent, please provide us with your landlord's name and phone number. Please note that we will contact your landlord.
8) If you move to a location that does not accept dogs, what will you do?
9) If you have children living in your home or that visit on a regular basis, please indicate their name, sex, and age(s).
10) Are there other adults in the household? How many?
11) Do all adults in the house approve of getting a dog?
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Yes
No
12) How many hours will this pet be alone most days?
13) Have you ever owned a dog of this same breed?
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Yes
No
14) If you have other animals, please fill out the section below listing, species, breed, age and whether they are spayed or neutered.
15) If you have owned animals in the past, what happened to those pets? (i.e. Put to sleep because of old age or health, ran away or stolen, given away to to a family member, released to animal shelter, given away through newspaper ad?)
16) Do you take your pet to a vet annually?
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Yes
No
17) Are your current pets current on their vaccinations and heartworm preventative (where applicable)?
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N/A
Yes
No
18) Are you familiar with heartworm preventative and the vaccinations that are necessary?
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Yes
No
19) We require that all animals adopted from us be spayed/neutered. If you have any questions/concerns/reservations about this policy, please explain below.
20) Are you prepared for the possibility of more than routine vet bills and care of the dog?
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Yes
No
21) If you have animals in the house that are not spayed/neutered, fully vaccinated, and on heartworm/flea prevention medicine - please explain.
22) Please provide us with the name/address/phone number of your veterinarian. We will call them for a reference.
23) Do you have a fenced yard?
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Yes
No
24) What kind of fencing do you have?
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None
4 Ft. Chain Link
5 Ft. Chain Link
6 Ft. Chain Link
4 Ft. Privacy Fence
6 Ft. Privacy Fence
Chain Link/Privacy Combo
Invisible Fencing
Electric Fence
Dog kennel
Chicken Wire/Cattle Fence
Other
If other, please indicate
25) If you DO NOT have a fence, how will your new dog be exercised and go to the bathroom?
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N/A
Paper-Train
Turn Loose Outside
Tie-Out/Runner
Leash Walks
Other
If other, please specify where
26) Would you allow a home visit by a volunteer on behalf of rescue?
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Yes
No
27) Where do you plan to keep your new dog the MAJORITY of the time?
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Inside
Outside
Garage
Basement
Crate/Cage
Other
If other, please specify where
28) Where will your new dog sleep at night?
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Inside
Outside
Garage
Basement
Crate/Cage
Other
If other, please specify where
29) What will you do with your new dog when there is no one home?
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Inside
Outside
Garage
Basement
Crate/Cage
Other
If other, please indicate
30) What will you do if your new dog exhibits bad behavior? ie..being destructive, soiling the house, barking, etc.
31) Do you understand that a dog may not be housebroken and are you willing to take the time to properly housetrain?
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Yes
No
May Be
32) Do you understand that it may take this dog time (at least 30 days)to adapt to his new environment and family?
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Yes
No
May Be
34) Would you be willing to adopt a dog with a medical condition (allergies, thyroid problem, etc). Note: We will not adopt out a dog with a major medical problem such as cancer.
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Yes
No
May Be
33) What are your preferences for your adopted dog? ie..age, sex, color, etc.
35) Would you be willing to adopt a dog with a behavior problem (chewing, separation anxiety, fear of thunderstorms, not housebroken, etc.) Note..we will not adopt a dog that is aggressive or has bitten before--under ANY circumstances.
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Yes
No
May Be
36) Did you see a particular dog on our website that you are interested in? If so, please indicate below
37) Please give 2 references, one must be professional.
38) Please write any additional comments below. Use this space to also indicate any health or behavior problems that you could NOT handle or why you think we should consider you for adoption!
