Dog Adopter Survey
Help us find your match!
Name
*
First Name
Last Name
I am over 18 years of age:
*
Yes
No
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
This is my primary residence and I:
*
Own
Rent
Not my primary residence
Other
Email
*
example@example.com
I am interested in adopting:
*
Write name(s) of dogs you are interested in meeting.
The last time I owned a dog was:
*
Currently own dog(s)
Not currently but within the last two years
2 - 10 years ago
Over 10 years ago
Family dog growing up
I have never owned a dog
I am looking for a dog that can be a (select all that apply):
*
guard dog
hunting dog
herding dog
emotional support animal
service dog
trial dog (obedience, fly ball, agility)
companion
Other
My new dog needs to get along with other dogs (please consider other dogs in your neighborhood or dogs belonging to family members or roommates, and if you plan on taking your dog to activities outside the home):
*
Yes
No
My new dog needs to get along with (please consider family, friends and activities outside your home) - select as many as apply:
*
Babies and toddlers
Children 4-8
Children over 8
Seniors
Cats
Farm animals (chickens, sheep, cattle, horses, etc.)
Small animals (rabbits, guinea pigs, birds)
Other
My new dog will primarily be:
*
An outside dog
An inside dog
An inside - outside dog
A traveling companion
Where ever I am
Where ever the dog prefers
My new dog will need to be able to be left alone an average of (per day):
*
Less than 2 hours
2 - 4 hours
4 - 8 hours
8 - 12 hours
12 or more hours
When I am not at home, my new dog will spend their time - select all that apply:
*
In the yard
Loose in the house
Confined to one room in the house
In a crate
In the garage
I am familiar with crate training a dog:
*
Yes
No
Not Sure
When I am home, I want my new dog to be by my side:
*
All of the time
Some of the time
Occasionally
Never
I am looking for a dog that is (select activity level) 1 = Couch Potato, 5 = Very Active):
*
1
2
3
4
5
Couch Potato
Very Active
1 is Couch Potato, 5 is Very Active
I am looking for a dog that is:
*
Rows
Not Important
Somewhat Important
Very Important
Extremely Important
Playful
Affectionate
Laid back
People friendly
I am comfortable working with my new dog to improve their behavior (jumping, pulling on the leash, shy, etc). 1 = Not at All, 5 = Very Comfortable
*
1
2
3
4
5
Not at All
Very comfortable
1 is Not at All, 5 is Very comfortable
I would be open to adopting a dog with "special needs":
*
Medical
Behavior
Maybe
Not at all
The most important thing to me is that my new dog . . .
*
Is there anything else you'd like to add:
Submit
Should be Empty: