Adoption Questionnaire
Adopter names
Email
example@example.com
Date
/
Month
/
Day
Year
Date
Phone number
Format: (000) 000-0000.
Animals interested in name and species
Personal Lifestyle
Homebody
Active
Frequent Traveler
Children In the Home
Yes
No
If yes how many and what are their ages
Other Animals in the home?
Dogs
Cats
Exotics
Other
Are all animals spayed or neutered?
Yes
No
Are all animals spayed or neutered?
Yes
No
Some
Type of Home
House
Apartment
Mobile Home
Other
Do you rent or own?
Rent
Own
If renting, does the lease allow pets?
Yes
No
Is the yard fenced?
Yes
No
If Yes, what type and height?
If no what is your potty plan for dogs?
Has the applicant owned this type of animal before?
Yes
No
Desired qualities in a pet (check all that apply)
Calm
Active or high energy
Social
Senior or geriatric
Low maintenance
Playful
Special needs okay
Reason for adopting
Who will be the pets primary caregiver
How many hours a day will the pet be left alone
Where will the pet stay during the day
Where will the pet sleep at night
Does the applicant have experience with:
Reactive or aggressive dogs
Training or behavior work
Medical or special needs animals
Are you prepared to cover future veterinary costs?
Yes
No
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