Tri-County Animal Protective League

Dog adoption questionnaire

PLEASE BE SURE TO ANSWER ALL OF THE QUESTIONS - THANK YOU! Please note that filling out this questionnaire will not guarantee an adoption - you will be contacted by an adoption counselor for the remainder of the adoption process. Your name:  Your street address:  City:  State:  Zip:  Your phone number:  Your email address:  Which dog are you interested in adopting?  Are you currently employed?  Yes     No How long have you been working there? Are you 21 or older?  Yes     No Do you own or rent your home?  Own     Rent If you rent, please give the name and phone number of your landlord. PLEASE NOTE: Renters must provide proof that they are permitted to have a pet.  Tri-County APL can verify this by calling your landlord, or you can provide written proof to us.  We must verify this before completing an adoption.  If your lease requires that you fulfill an extra requirement to have a pet (such as an extra security deposit), we'll need verification that this was done, also. How long have you lived at your current address?  Do you anticipate moving anytime in the next few years?  Yes    No How long have you been thinking about adopting a dog?  Where have you looked so far?  Why do you want to adopt this dog? (check all that apply) Companion For children Company for other pet Gift Protection To breed Hunting Mouser For barn Other (please explain):  Where will this dog live?  Please Choose One Inside always Inside/outside Primarily outside Are you aware of the normal life expectancy of this dog?  Yes     No What would you do with this dog in the event of a crisis? (Loss of job, having to move, etc...) Do all adults in your home approve of adopting a dog?  Yes     No Please give the ages of everyone living in your household. If children are in the home, are you willing to educate and supervise in the proper care and treatment of this new dog? Yes     No     No small children This can include things such as making sure children don't let the dog out an open door by accident; and supervising the dog and children, as you teach the children safe behavior around dogs (for safety, most experts recommend never leaving young children alone with a dog). Who will be the primary caretaker of this dog?  Does anyone in your household have allergies to dogs?  Yes     No     Not sure Would you object to a follow-up call or visit from the Tri-County APL?  No     Yes Do you have any pets now?  Yes     No How many pets do you have and what kind are they? Are they all spayed or neutered?  Yes     No     No other pets If not, please explain why not.  What happened to the most recent cat or dog you lost? What is the name of your veterinarian or vet clinic?  If you don't have a vet now, where will you take this dog for medical care?  What do you do (or plan to do) to control fleas?  Why is spaying and neutering important? What is your estimated annual cost for medical care, feeding, and licensing this dog?   Where will this dog be kept during the day?  Where will this dog be kept during the night?  If you go away on vacation/emergencies, who will care for your dog(s)?  How long will you give this dog to adjust to its new home?  How would you handle behavior problems? For what reasons would you return this dog? (Check all that apply): House soiling Chewing Biting/nipping Scratching Grew too large Too much shedding Could not control Others in household didn't like/want Poor hunter Did not have enough time to spend with pet Couldn't afford Didn't get along with children Other (please explain):  Is your yard fully fenced in? (Please note that a fenced yard is not required for adoption, except in special circumstances, but is highly recommended) Yes    No If your yard is fenced, what type of fence is it?   Do you agree never to let this dog outside unless it is on a leash/tieout or inside a fully fenced yard? Yes    No Do you plan on taking this dog for obedience training?  Yes    No How do you plan on housetraining this dog? Do you own a crate?  Yes    No     No, but plan to buy one Do you know how to crate-train? Yes    No    I don't know what crate-training is Please give me more information on crate-training when I adopt this dog! If you have a dog now, is it on heartworm medication? Yes     No     I don't have any other dogs. Why is it important to give dogs heartworm medication? THANK YOU FOR YOUR INTEREST IN ADOPTING A DOG!