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Name:
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Email Address:
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Work Phone:
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Cell Phone:
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Home Phone:
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Please enter your full address (include house/apartment #/street/city/state/zip
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Do you rent or own?
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Rent
Own
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If you rent please provide your landlord's name, address and contact phone number.
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Which dog are you applying for?
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Why did you choose this dog?
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Please list the pets you currently own. Give the species/name/sex/age/breed/spayed or neutered?
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If you currently own pets, please give your veterinarian's name, address and phone number.
If you do not have a vet, please be aware that you will need to have chosen a vet before you are pre-approved to adopt.
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How many hours a day will this dog be left home alone?
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0-3
4-6
7-9
10+
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Where will this dog be kept when you are not at home?
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Inside house, loose
Inside house, crated
Inside house in a laundryroom/bathroom, etc.
Outside in fenced yard
Outside in dog run
Outside loose
Outside tied up
Taken to Dog Day Care
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Please describe, IN DETAIL, your IDEAL dog. Give us a WISH LIST of qualities that you would like your dog to have.
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Do you have a fenced in yard?
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Yes
No
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If you have a fenced yard, how tall is the fence and what it is made of?
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If you DO NOT have a fenced yard, how do you plan to exercise and give your dog(s) potty breaks?
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Does anyone living in your household have allergies to dogs or cats?
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Yes, allergic to cats
Yes, allergic to dogs
No
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Have you heard of Heartworms in dogs? Please tell us what you know about them.
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How often do dogs need to be given Heartworm prevention?
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Daily
Weekly
Monthly
Once a year
Only when it's hot
Never
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Do you have children? What are their ages? Have your children had pets before?
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Which of the following would cause you to give up your dog?
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Divorce
Death in family
Birth of child/pregnancy
Loss of job
Unable to house train
Chewing/Destructive behavior
Digging
Barking
Shedding
Aggression towards people
Aggression towards other animals
Moving to new home/apt.
Other
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What would you do with your dog if you had to find him/her a new home?
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What will you do when you go out of town?
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Board at vet
Board at dog day care
Have neighbor come in to care for
Take to relatives house
Have petsitter come to house
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How often do dogs need to receive vaccinations?
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Twice yearly
Once a year
Every 2 to 3 years
They don't require more vaccinations once they've finished their puppy shots.
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Have you ever house trained a dog before? If YES, what method did you use?
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Do you realize you will have acess to a free training class if you adopt this dog? Are you interested in training your dog?
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Yes
No
Maybe
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