Language
English (US)
Contact Information
Owner's name
*
Address
*
Phone number
*
Email address
*
How did you hear about Aska's Animals?
*
Adopted from Animal Adoption Center
Contacting or visiting Animal Adoption Center
Another shelter/rescue
Veterinarian
Website/Online Search
Friend/Family Member
Facebook
Instagram
Newspaper
Other
Pet Information
Dog's name
*
Age
*
Gender
*
Intact female
Intact male
Spayed female
Neutered male
Breed(s) or best guess
*
Where did you get your dog?
*
Do you know any history on your dog prior to adoption, if applicable?
*
How long have you had your dog?
*
Who is your veterinarian?
*
Does your dog have any medical issues, including allergies? If so, please describe.
*
If your dog is taking any medication, please list the drug and dosage
*
What brand of food do you feed?
*
How many cups of food do you feed each day?
*
What is your dog's feeding schedule? Check all that apply
*
Food is available all/most of the time
Scheduled Meals
My dog eats immediately and finishes her food
My dog is a picky eater and takes her time or grazes
What are your dog's favorite treats or snacks?
*
What are your dog's favorite toys or games? (ex. fetching ball, frisbee, tug of war, etc.)
*
Has your dog received any formal training? If so, please list the trainers/organizations you've worked with
*
Please check all the equipment you've used with your dog
*
Flat collar
Harness-front or back clip
Head halter - gentle leader, etc.
Choke chain/training collar
Pinch/prong collar
Bark collar
Electric collar
Invisible fence
Crate
Exercise pen
Baby gate
Tether (for time outside)
Long line
Thundershirt
Other calming products (aromatherapy, collars, herbs, etc.)
Describe your dog's exercise routine (activity, distance/duration, frequency, locations, etc.)
*
Where does your dog sleep at night?
*
What is your typical schedule for work or school?
*
Where is your dog when left alone?
*
How often is your dog left alone?
*
Household Information
If you have other people in your household, list them below (please include ages of children)
*
Describe your dog's behavior and relationship(s) with human family members
*
If you have other pets in your household, please describe them below (species, breed, age, gender, spayed/neutered, etc.)
*
Describe your dog's behavior with other pets in the household.
*
How does your dog react when strangers come to the door?
*
How does your dog react after guests enter your home?
*
Behavior concern
Describe your dog's concerning behavior. Please be as detailed as possible (where it happens, how often, specific details, etc.)
*
When did this behavior start?
*
Were there any environmental or lifestyle changes that occurred around the time your dog's behavior changed? If so, please describe. (ex. moved, had baby, different roommates, job schedule change, etc.)
*
What do you do when your dog exhibits this behavior?
*
How does your dog react to your response?
*
What changes (if any) have you made due to your dog's behavior?
*
Have you consulted your veterinarian about this behavior? If so, what was the result?
*
Has your dog ever bitten or injured a person? If so, provide details including circumstances leading to the incident, nature of injury, and level of medical attention needed.
*
Has your dog ever bitten or injured another animal? If so, provide details including circumstances leading to the incident, nature of injury, and level of medical attention needed.
*
Are you considering re-homing your dog?
*
Is your annual income greater than $50,000?
Yes
No
Submit
Should be Empty: