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Pre-Adoption Questionnaire
We just need a few details from you so we can find the perfect dog for you. Please answer honestly so we find the right match.
First Name
*
Last Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
Town
County
Postcode
Contact Telephone Number 1
*
Contact Telephone Number 2
If applicable
Email address
*
Character Reference 1
*
Character Reference 2:
*
Do you give permission to Hero Paws SCIO to contact your references
*
YES
Are you planning to move house in the next 6 months?
Yes
No
Do you have any medical conditions we should be aware of?
Yes
No
If YES, please advise.
Facebook Profile
Instagram Profile
Twitter Profile
TikTok Profile
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A LITTLE BIT ABOUT YOUR HOME
Property Type
*
Detached
Semi detached
Terraced House
Apartment/Flat
Bungalow
Mobile Home
OTHER
Is your home
*
Owned
Rented
If your home is rented do you written permission from your landlord to house a dog?
Yes
No
Is the garden secure
Yes
No
Please provide details of provisions to prevent escape
A LITTLE BIT ABOUT YOUR FAMILY
Who lives with you?
Please Select
Only You
Myself and Other Adults
Myself and Other Adults and Children
Myself and Other Children
How many Adults?
Please Select
1
2
3
4
5
6
How many Children?
Please Select
1
2
3
4
5
6
How many children are under 16 and their ages
Please tell us how many children under 16yrs visit regularly. Please state their ages.
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ARE YOU INTERESTED IN
Size of Dog
*
Please Select
Small Dog (eg. Spaniel)
Medium Dog (eg. Labrador)
Large Dog (eg. German Shepherd)
Any Size
Gender of Dog
*
Please Select
Male
Female
Either
Age of Dog
*
Please Select
Less than 2 Years old
2 - 5 Years old
5 - 8 Years old
8 Years +
Any age
Do you own any other pets
No
Cat
Bird
Rodent
Other
Do you own any other dog/dogs ? If yes, Please give details, how many, ages etc.
YOUR IDEAL DOG WOULD BE
Doggie Traits
*
Not Important
Quite Important
Very Important
Be house trained
Comfortable around children
Enjoy being petted & picked up
Good with cats
Good with livestock
Like other dogs
Like strangers
Like travelling in the car
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A LITTLE BIT ABOUT YOUR LIFESTYLE
How active are you?
*
Not very
Reasonably
Very
How much daily exercise do you expect to give the dog?
*
Would this be in the
*
Morning
Afternoon
Evening
How long do you expect to leave the dog alone on a regular basis?
*
YOUR EXPERIENCE
YOUR DOGGIE EXPERIENCE
NO
YES
You are a first time dog owner
You have trained a dog before
You have trained a challenging dog before
You need a dog already trained
You would enjoy training a dog
Have you owned a dog before, if so what breed.
Any other relevant information?
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Date of submission
*
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Agreement and Confirmation; I confirm that the information provided in this questionnaire is true and complete to the best of my knowledge. I understand that this form does not guarantee adoption but is part of the assessment process. By submitting this form, I agree that I am applying in good faith, and I accept that this typed name and ticked confirmation below will act as my digital signature for the purposes of this application.
*
I Agree
Please type Your Full Name below (acts as your digital signature)
*
Submit
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