Dog Match Request Form

1
The purpose of this form is to find you a match with a rescue dog based on your needs, wants, and situation not just the superficial characteristics like breed/size/age. Whether that's with my rescue or a different rescue, I just want to help dogs find FOREVER homes.

Please note that any rescue you get matched with, including mine, will require the completion of an adoption application. But you'll already know that you are a match!

Your information will be shared with other rescues if they have a dog that fits your lifestyle so by completing this form you agree to your information being shared with them.
2
Name* This field is required.
First Name
Last Name
3
Email* This field is required.Please double check the spelling as I won't be able to contact you if the email bounces back
example@example.com
4
Phone NumberNot required but good to have as a back-up in case there are issues with email
Area Code
Phone Number
5
Zip Code* This field is required.
6
What type of home do you live in?* This field is required.
House
Condo/Townhome
Apartment
Mother-in-law suite
Farm/Rural property
Other
7
What kind of outdoor access will your dog have?* This field is required.
Fenced yard
Unfenced yard
No yard but dog park/trails close by
No yard but leash walks
Large rural property
Other
8
Are there are other pets in the home?* This field is required.
Dogs
Cats
Birds
Livestock
Reptiles
No other pets
Other
9
Are there children in the home (full time or part time or visiting regularly)?* This field is required.
YESNO
10
What best describes the children's experience level with dogs?* This field is required.
Very comfortable and used to being around dogs
Some experience but still learning
Limite or no experience with dogs
One or more children are nervous arounds dogs
N/A
11
How active is your household?* This field is required.
Mostly calm/low activity
Moderate activity (walks, outings, etc)
Very active (hiking, running, outdoor lifestyle)
12
Which of these activities would you want your dog to be involved in?* This field is required.Select all that apply
Walks in an urban environment
Walks in a park/wooded area
Short hikes
Long hikes (all day or overnight)
Off leash dog parks
Camping
RV travel
Other travel
Gatherings at your home
Gatherings at other people's homes
Dog friendly bars/restaurants
Large gatherings such as farmers markets, sports events, block parties, etc
Boating
Beach/lake days
Fishing
Hunting
Working the farm
Other
13
About how many hours would the dog be alone on a typical day?* This field is required.
0-2 hours
3-5 hours
6-8 hours
More than 8 hours
14
Have you owned a dog as an adult and main caregiver?* This field is required.
YESNO
15
Which type of dog personality would fit your home best?* This field is required.
Calm/lower energy
Moderate activity tolerance
High activity tolerance
Not sure
Other
16
Are there any traits that are especially important to you?* This field is required.Select all that apply
Must be good with cats
Must be good with other dogs
Must be good with young children
Must be good with birds
Must be good with livestock
Must be good with small animals (rabbits, hamsters, etc)
Must be affectionate
Must be independent
Other
17
Which sizes would you consider?* This field is required.Select all that apply
small
medium
large
extra large
18
Which image speaks to you the most?* This field is required.
19
What are the 1-3 main reasons you want a dog?* This field is required.Select all that apply
Companion for yourself
Dog for your children
Dog for you and your partner
Cuddle buddy
Adventure buddy
Working dog/farm dog
Emotional support
Service dog
Playmate for resident dog
Protection/deterrent
Workout buddy
Social butterfly
Other
20
Why do you want a dog RIGHT NOW?* This field is required.
21
Describe a normal day with your new dog as you envision itOptional
Huge
Large
Normal
Small
Ok
Ok
22
Anything else you think is important to know (restrictions, preferences, limitations, etc.)
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: