Send to AdoptAPetCA@aol.com
Name.......................................Age....
Name of Spouse.............................Age....
Street Address....................................
City/State/Zip....................................
Home Phone #...................Wrk #..............
Occupation..................Spouses...............
Name/Age/Relationship of others in household
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Are you prepared to keep this dog for 16 yrs?.....
Do all family members want a dog now?.............
Visiting children's ages..........................
Do you have a nanny/maid/babysitter?..............
What would you do if a dog growled at a child in your home?........................................
Who will be responsible for feeding/care of the dog?..............................................
How many hours a day will dog be alone?...........
Is anyone able to visit dog midday?...............
Where would dog be left when alone?...............
Where will dog sleep at night?....................
How many hours a day will dog be inside with family?..........
Has any member of family experienced pet allergies?........
Under what circumstances would dog be required to start living outside?...........................
Will dog have shelter if outside?.................
Do you plan to use a crate/cage inside home?......
What is maximum amount of time dog will be enclosed in crate?..............
Do you travel frequently or are you in military?.....
What do you do with dog when traveling?...........
Have you ever had any animal hit by car?..........
What was the cause?...........................
Have you ever had animal run away/stolen?.........
Have you ever given an animal away?...............
Are you willing to attend dog obedience classes?.....
What form of discipline do you use on dogs?.......
Do you live in house, apt, or trailer?............
Do you rent or own your home?.....................
What kind and height of fencing do you have?...........
What type and height of gates?....................
Do you have a pool/spa?...........................
Do you use poolmen/gardner?.......................
Are there size restrictions on pets you may have?.........
Is it okay for an adoption volunteer to visit your home?........
Are you planning a move?..............
Under what circumstances would you not keep the dog?
Divorce.................
Illness.................
Moving/job..............
New Baby................
Dog misbehaving.........
Other...................
None of the above.......
What veterinarian will you use?..................
Will the dog ever be around horses?..............
Outside of your home or fenced yard, where do you feel it is safe to have the dog off leash?.......
Describe Current Pets
Include Breed/type
How obtained
Age
Sex
Spayed/neutered
inside/outside
Disposition
Weight/height
Please describe past pets
breed/type
how obtained
how long did you keep pet
your age at the time
where is pet now (if deceased, state cause of death
