Desired Adoptable Dog
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Name
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First Name
Last Name
Phone
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(###)
###
####
Email
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Occupation
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Year you were born
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Name of Spouse / Partner
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First Name
Last Name
Children (with ages)
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Is your home a(n):
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House
Condo
Apartment
Do you rent or own?
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Rent
Own
Provide Landlord's name and number:
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List any additional people in household:
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Has anyone in your household experienced allergies or asthma?
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Why are you looking to adopt a dog?
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Check all that apply.
If "GIft" or "Other", please explain:
Who will be responsible for the dog's care (feeding, exercise, training, potty walks, vet visits, socialization etc)?
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Are you prepared to care for this dog for it's life span of 10-15 years? *
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Who will provide for your pet in the event that you become ill or unable to care for him/her?
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Do you have any of the following?
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Please check all that apply.
Do you have a fence?
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Yes
No
Describe your fence including all heights, materials, gates/openings. Is the fence intact on all sides? Are there locks at each gated opening?
Where will your dog sleep at night?
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How many hours a day will your dog be left alone?
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Where will (s)he be left alone?
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How often will your dog be exercised? (not including short potty walks)
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Will this be your first pet?
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Yes
No
Please list pets you've previously owned (type, age)
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What happened to pets previously owned? If deceased, please list cause of death.
Do you have any other pets in your home?
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Yes
No
Please list names, types, ages of current pets in home:
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Do you have a veterinarian?
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Yes
No
Provide us with your veterinarian's name, locations and phone number.
If you currently have dogs/cats, are they spayed/neutered?
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Yes
No
No pets
Are your pet's vaccinations up-to-date?
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Yes
No
No pets
When was their last visit to the veterinarian?
Year must be 4 digits.
MM
DD
YYYY
Are you prepared to cover any vet expenses that you may incur throughout your dog's life?
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Yes
No
If yes, is there a limit to vet expenses over your pet's lifetime? If so, what is the limit?
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Do you plan on purchasing pet insurance?
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Yes
No
Maybe
How do you plan on keeping your new pet's teeth clean?
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What traits are you looking for in a dog?
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Are there any behaviors that would be unacceptable to you?
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How do you plan on training your dog?
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Would you be willing to hire a professional trainer to help with any major behavioral issue?
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What amount of time do you think is reasonable for your dog to adjust to you and your home?
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What will you do with your new dog if the following 7 situation occurred?
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1) You move to a new home that does not allow pets?
2) You move to a new home that does not allow pets?
3) You get married? (if you're single)
4) A new boyfriend/girlfriend is allergic to dogs?
5) You travel?
6) You move locally?
7) Move out of state or country?
Under what circumstances would you not be able to keep this dog?
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Under what circumstances would you not be able to keep this dog?
If you chose "other", please explain:
If you have to give up this dog for any of the above checked reasons, what will you do with the dog?
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Were you ever in a situation where you were not able to keep a pet?
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Yes
No
If you answered yes, please explain:
Are you willing to have an AWF representative visit your home?
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Yes
No
Are you willing to have an AWF representative visit your home?
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I certify that all of the above information is true and accurate. I understand that if I adopt a pet from the Animal Wellness Foundation, this document will become part of the adoption record. I also understand that completion of this questionnaire does not guarantee the adoption of an AWF dog.
First Name
Last Name
Date of signature
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Year must be 4 digits.
MM
DD
YYYY
