Pre adoption questionnaire
You must fill out this form in its entirety if you are interested in adopting the listed dog. We will review applications within two working days and if your home is a good fit, we will notify you. By submitting this form, you give us permission to contact you, your vet and the references listed on this application.
Name
First Name
Last Name
Where did you hear about the listed dog?
Address
Address
Street Address Line 2
City/State/Zip
State / Province
Postal / Zip Code
Phone
Email
example@example.com
Type of residence
Single family home
Townhome
Condo
Apartment
Farm/ ranch
Other
Residence details
Own
Rent
Live with parents/ guardian
Other
Is your yard fully fenced?
Yes
No
No yard/ not applicable
Do you have a pool?
Yes - fenced off
Yes - not fenced
No
Do you have a doggy door?
Yes but can't be locked
Yes but can can be locked
No
What is your occupation?
Employment Status
Full time
Part time
Other
Do you work from home?
Please Select
Yes
No
Not applicable
List all of the residents in your household and include their name, age and relationship to you.
List all the pets you currently own, including name, breed, gender, age and how long you have had them.
Do all the family members in your house want a dog?
Please Select
Yes
No
Is anyone in the house allergic to dogs?
Please Select
Yes
No
Are your pets up to date on their vaccines?
Please Select
Yes
No
Not applicable
Are your pets spayed/ neutered?
Please Select
Yes
No
No - but plan to get them spayed/ neutered
Not applicable
Are your pets on heart worm preventative, flea and tick, and dewormer?
Please Select
Yes
No
Heartworm only
Flea & tick only
Dewormer only
Flea & tick and dewormer only
Not applicable
Have you had pets before? If so, explain (e.g. how long you had them, when you had them, type of pet, breed, why you gave them up etc).
Have you ever surrendered a dog and for what reason?
How often do you plan to exercise your dog and how will you exercise your dog?
Where will the dog sleep?
Will the dog be kept indoors or outdoors?
Where will the dog be when alone?
How many hours will the dog be alone every day?
What are your plans for training?
What are you looking for in a dog?
What qualities would you like in a dog?
What qualities would you dislike in a dog / not be able to train them on?
Do you have a vet?
Please Select
Yes
No
No - but plan to get one
No - but have one in mind
If you have a vet, what is the name of the vet?
Are you capable of providing healthcare and looking after this dog for the next 10 to 15 years?
What will you do with this dog if you move?
Are you familiar with crate training?
Please Select
Yes
No
Do you own a crate?
Please Select
Yes
No
Will you crate your dog?
Please Select
Yes
No
Not sure as I am not familiar with crate training
How will you groom/ bathe your dog?
Have you looked into purchasing pet insurance and will you be purchasing pet insurance?
Yes I know which insurance I will purchase
Yes I have looked into it but I won't be purchasing pet insurance
No I have not looked into it insurance but plan to
No I will not be purchasing pet insurance
Other
What is your $ limit for annual vet visits?
Type approximate $ limit
Reference 1 name
First Name
Last Name
Reference 1 number
Please enter a valid phone number.
Reference 1 relationship to you
Reference 2 name
First Name
Last Name
Reference 2 number
Please enter a valid phone number.
Reference 2 relationship to you
Save
Submit
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