Adoption Inquiry Form
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
I am looking for a
Dalmatian
Dalmatian Mix
Will this be your first Dalmatian
Yes
No
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Gender preference
Male
Female
No preference
Which special needs can you accommodate
Deaf or hearing impaired
Blind or sight impaired
Urinary issues (stones, chronic UTI, incontinence)
Seizures
Allergies
Special diet
Anxiety
Fearful
Bite history
Prey drive
Cat intolerance
Dog intolerance
High intensity exercise
Senior (10 or older)
Child intolerance
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How many people live in your home
Are children under the age of 12 living in or frequent visitors of your home
Yes
No
Do you own your home or rent
Own
Rent
Are there limitations on the size or type of animal you may have
Yes
No
Do you have a fenced yard?
Please Select
6 foot or taller
Under 6 foot
No fence
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Tell us about other pets in your home
On average, how many hours a day are you away from home?
Where will the dog be while you are away?
What is your plan for exercising your Dalmatian?
Submit
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