Adoption Consultation Form

Adoption Consultation Form
San Tan Animal Rescue uses this form to help us understand your needs and your expectations. This information will help us in selecting the animals we believe will be a good match for you and your family. Adopting an animal is a big decision and a lifetime commitment, so please help us in making a successful adoption!
Name

First NameLast Name
Address

Street Address

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
TELL US WHICH DOG YOU ARE INTERESTED IN:
What age dog are you looking for

0-1 Year2-4 Years4-6 YearsOver 6 Years
What gender of dog are you looking for

MaleFemaleAny Gender
What personality characteristics do you want your new dog to have?

High ActivityMedium ActivityLow Activiy
We want our new dog to do the following with us:

HikeCampPlay ballSwimRelax in the eveningWalkOther
We want our dog to be:

CompanionObedientProtectiveService
We want our new dog to be:

IndoorOutdoorIndoor MostlyOutdoor Mostly
Have you adopted an animal from STAR before?

YesNo
Have you had animal's before?

YesNo
What happened to them?

Still have themDiedGave AwayOther
How many animals do you now have?

123Other
What kind of animals?

DogCatOther
Age / Breed / Spayed / Neutered
Age / Breed/Spayed/ Neutered
Shots up to date?

YesNo
About your home

RentOwnOther
If you rent does your landlord allow animals?

YesNo
Does your home have a dog door?

YesNoConsidering installing one?Other
Is your yard fenced?

YesNo
What type of fence

BlockWoodChain LinkOther
How tall is your fence?

4 foot5 foot6 footOther
Does your home have a pool?

YesNo
Is your pool fenced?

YesNo
How many Children live in your home:
Ages of the children that live in your home:
How many adults live in your home:
Ages of Adults in the home:
Is anyone in your home allergic to dogs/cats?

YesNo
Children visit the home?

DailyWeeklyMonthlyDuring the Holiday'sNever
How many hours per day would your new dog be unattended while your family is at work or school?

0 Hours1-3 Hours3-6 Hours6-9 Hours9 +
Where will your dog be kept during the day while you are away?

InsideOutsideInside/OutsideOther
Where will your dog be kept during the night?

InsideOutsideOther
Our family’s activity level is:

very active & always on the gomoderately active, at home a few nights a weeknot very active, at home 5 – 7 nights a weeksomeone is always at home
When you are out of town, do you plan to:

take your dog with youleave your dog with family/friendsleave your dog home aloneBoard your dog
If you would have to move you would:

take your animal with youfind your animal another homereturn them
Are you familiar with crate training?

YesNo
Will you crate train?

YesNo
Would you be willing to take your dog to obedience training?

YesNo
How much are you willing to spend on medical expenses per year for your dog?

$0-$100$100-$200$200-$500$500-$800No Limit
I acknowledge that all the information contained in this form is true and correct to the best of my knowledge. I understand that any misrepresentations of fact maue.y result in the removal of the adopted dog from my home by San Tan Animal Resc
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