| Full Name | |
| Address | |
| City, State, Zip |
|
| Home phone number | |
| Alt phone number | |
| Email address | |
| Home situation? Rent or Own. | |
| House, mobile home, or apt.? | |
If renting, name/number
of landlord |
|
Please describe your yard/property
(size, shade trees, etc.) |
|
| Describe the type of fencing | |
Number of all adults and
their ages in the household |
|
Number of all children and
their ages in the household |
|
Are all family members in
agreement for adoption? | |
| List other pets living in the home |
|
| Are they on heart worm preventative? | |
| Current on ALL vaccines? | |
| Describe living arrangements for pets |
|
| Have you ever given up a pet? | |
| If so, please explain the circumstances |
|
How many hours a day will
this pet be alone? |
|
What accommodations are in
place for alone time? |
|
| Where will this dog stay at night? |
|
How often do you plan to
exercise this dog? |
|
Does your commitment to your new
pet include working through issues
(ie: fear of strangers, chewing,
fear, separation anxiety, walking on
leash, jumping a fence)? |
|
Describe the activity level
of your household. |
|
| How often do you travel? | |
What arrangements are in place
for when you travel? |
|
| Veterinarian name and number. |
|
Are you familiar with the use of a
dog crate to train your pet? | |
Are you planning to continue
the use of crate training? | |
| Which pet are you interested in? | |
Why are you interested in
this particular pet? |
|
| Would you like a recommendation of a pet? | |
Would you be interested in
becoming a foster parent? | |
| What do you like BEST about dog ownership? |
|
What do you like LEAST
about dog ownership? |
|
| Comments |
|
|
| |
|
