PAWS FOR PROGRESS Dog Questionaire

Paws for Progress

Pawsladonia@gmail.com
PAWS FOR PROGRESS Dog Questionnaire
DOG ADOPTION QUESTIONNAIRE
It is our policy to make certain that each person who adopts a dog/cat is aware of the responsibilities of pet guardianship, and is capable of and willing to accept those responsibilities morally, physically and financially. Not every person who desires to adopt a dog/cat should do so. By completing this questionnaire, you will aid us in determining if you and your family are indeed ready for pet guardianship, and if the dog/cat of your interest would suit you and your lifestyle. Should you agree that adopting a pet is a commitment throughout the lifetime of your companion animal, please fill out this questionnaire.
Name of DOG OF INTEREST*
PERSONAL INFORMATION
Name
Age
Street address
City
State
Zip
Home phone
Work phone
Cellular phone
Email
example@example.com
Occupation
Work schedule hours
Spouse/Significant Other's name
Email
example@example.com
Spouse/Significant Other's occupation
Spouse/Significant work hours
How many hours out of the day would your dog be alone?
If dog is alone for a long period of time during the day, would you hire a dog walker or take to a Doggy Daycare?

YesNo
If you travel, please specify arrangements for your pets while you are gone.
Who would be the primary person responsible for the dog?
List of all persons living in your household, their relationship to you and their ages.
Do any household members have allergies to animals?

YesNo
Please list two personal references and their relationship to you:
1) Name*
Relationship
Email*
example@example.com
Phone*
2) Name*
Relationship
Email*
example@example.com
Phone*
YOUR HOME
Type of Dwelling

HouseApartmentCondominiumOther
If renting, what are the association/owner rules about dogs?
If not a homeowner, do you have the landlord's permission to have a dog?
Landlord's name
Phone
Email
example@example.com
Does your home have a pool?

YesNo
Is you pool area fenced?

YesNo
How do you introduce a dog to a pool?
Do you currently own any pets?

YesNo
CURRENT DOG(s)/CAT(s)
Please list any pets currently living in the household. Include breed, age, sex, spayed/neutered, and disposition with other dogs/cats.
Family Veterinarian *
Clinic/Hospital Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone*
**If the pet you are adopting is not old enough for spay/neuter, within 30 days of being of age, we will send your veterinarian (stated above) a Certificate of Sterilization form to be filled out by the veterinarian and submitted back to us. If you choose a different veterinarian or clinic, please provide contact information to Paws for Progress via email pawsladonia@gmail.com**
Confirmation Signature verifying your dog will be sterilized within 30 days of being of age.

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What is your primary reason for wanting to adopt a dog?*

CompanionSecurityWorking DogEmotional Support AnimalFighting Dog
Paws for Progress will only adopt cats to homes where the cat would be strictly an indoor cat. Do we have your word that this cat will be indoors only and never be released outside intentionally?

YesNo
Where would the dog be when left if you are not at home?

IndoorsCrate indoorsOutdoor on propertyOutdoor KennelDoggie Door
How do you plan on exercising your dog? (Especially if living in condo/apt)
Do you feel obedience training makes a dog a better companion?

YesNo
If need be, would you attend obedience training for any behavioral issues?

YesNo
If you have to move and cannot take your pets with you, what provisions will be made for the your pets?
Under what circumstances would you decide that you can no longer keep your pet?

DivorceIllness in familyMovingNew babyNew jobHousetraining problemsChewingBarkingDiggingAllergyDog becomes ill/oldSheddingNot getting along with other house petsWould not give up for any of the above
If your dog becomes destructive in your home, what would you do?
If your dog has accidents in the home, what would you do?
If your new dog shows separation anxiety, what would you do?
If your dog becomes agressive towards people or other dogs, what would you do?
If you pet becomes ill or injured, are you financially prepared to care for the animal?

YesNo
Your pet could live 12+ years. What provisions will you make if you are physically or financially unable to care for your pet?
Is there anything else you would like us to know about you?
Would you allow an inspection of your home by a rescue volunteer?

YesNo
Questionnaire Information: All of the information I have provided in this Questionnaire is true and correct. If any of the information changes, I will advise you promptly.
Signature*

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PAWS FOR PROGRESS Dog Questionnaire

DOG ADOPTION QUESTIONNAIRE

PERSONAL INFORMATION

YOUR HOME

CURRENT DOG(s)/CAT(s)