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Today's Date
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First let's talk about you - what is your Name?
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What is your phone number?
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What is your street/mailing address?
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How long have you lived here?
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What is your email address?
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Do you rent?
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Yes
No
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If you do rent, Name & Phone number of Landlord
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Do you live in town?
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Yes
No
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Do you have a fenced in yard?
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Yes
No
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How did you hear about us? (i.e., friend, newspaper, etc.)
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Have you adopted from an Animal Shelter before?
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Yes
No
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If a pet has ever been removed from your home by law enforcement - provide details:
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Who will be the primary caretaker for this Dog?
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Please provide the name and contact information of your current vet:
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How would you describe your dog experience? (first dog, had several, very experienced, etc.)
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How many hours are you away from home per day?
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Where will your Dog live? (i.e., indoors, outdoors, both)
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If your Dog lives outside - what kind of shelter is provided & will s/he be tethered?
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Who shares your home with you? (how many kids, adults, etc)
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Describe your home atmosphere (ie, quiet, busy, etc.)
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Please describe your current pets:
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Do you spay or neuter all your dogs & cats)
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Yes
No
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Tell us what happened to pets that are no longer with you:
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Is there anything else you want us to know?
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Now about the Dog - what size are you looking for? (small, med, lg)
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What type of coat? (long, short, non-shedding, etc.)
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What age? (soft-spot for old dogs, 1-5 yrs, puppy etc)
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Training preferrence (housetrained, obedience, fully trained)
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What activity level should your dog be? (athletic, couch potato)
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Do you have a preference on gender, if so which?
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Please describe your ideal dog:
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