Name:
Address:
Telephone Number:
Cell Phone:
Email:
Please explain your reasons for wishing to adopt a dog.
For whom are you adopting a dog? For you or for someone else? (If for someone else, who?)
What experience do you have as a dog owner?
List all present and past pets you have been responsible for as an adult.
If your have been a dog owner, what happened to your dog (s).
Tell us about your previous dog(s).
Are you 21 years of age or over?
Where do you live? Do you live in a house, apartment, condominium or townhouse?
Do you own or rent your home?
How long have you lived at your current address?
Do you have children? If so, please list their ages.
Is any member of your family allergic to dogs?
Do you currently have any pets? And if so, what pets do you have?
What are their ages? What are their temperaments?
Who is your veterinarian?
What is your veterinarian’s phone number?
Do you have dog training experience? And if so, what training do you have?
What canine behaviour would you find totally unacceptable and why?
Describe your method of disciplining a dog? Examples: You have just come into the kitchen to find the garbage has been ransacked or the dog has had an accident in the house or apartment.
Are you willing to seek guidance/attend classes with your adopted dog, should you experience behavioural challenges?
List all members of your household. And which one will be primarily responsible for the care of this pet?
In what type of lifestyle do you want your dog to live? Inside, outside, both?
How many hours of the day will a dog be alone? And why?
Where would the dog be kept primarily? (house, yard, garage, other)
Where would the dog be sleeping?
Do you have a yard?
If yes, is the yard fenced? If your yard is not fenced, would you be prepared to have the yard fenced?
How many walks will the dog get per day?
Describe the exercise program that you have in mind for your adopted dog?
What type of food will you be feeding your adopted dog?
How will your dog be cared for if you have to be away from home for an extended period of time on vacation or for business?
Check any of the following reasons you would give your dog away
Fleas
Getting married or divorced
Allergies
Chews or destroys objects
Too expensive
Children no longer care for it
Having a baby
Moving where no pets allowed
Other (please explain)
Approximately how much do you think a dog will cost per year?
If your dog needs surgery and the fee is $2500, what would you do?
What are your thoughts on Pet Insurance?
Is there a specific dog that you would like to adopt? If yes, why do you want to adopt this dog?
What qualities are you looking for in a dog?
Would you have any objection to someone from our agency coming to your home to conduct a home check prior to the adoption of a dog?
Signature:
Please list three (3) pet references with phone numbers, not including your vet.
1.)
2.)
3.)