Name
*
First Name
Last Name
Phone
*
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Which dog(s) are you interested in? Please name.
What type of dog are you looking for?
*
Couch Potato
Medium Energy
Active or High Energy
What age dog are you interested in?
*
Young
Adult
Senior
How long have you been looking to adopt a dog?
How many adults (over 18) live in your home?
*
1
2
3
4 or more
If there are children (under 18) living in your home, please list their ages.
What age group does the primary care taker of the dog fall into? (Please note we do not adopt dogs to people under 25yrs of age.)
*
25-30
30-50
50-60
60-70
70-75
over 75
Do you live in a:
*
House
Duplex or Few Unit Building
Multi Unit Complex
Back House, Guest House, Mother-In-Law
Do you own or rent your home?
*
Own
Rent
If you rent, do you have approval from your landlord to get a dog?
Yes
No
If you rent, does your landlord have any breed or size restrictions? If yes, please describe.
Do you have a fenced in yard?
*
Securely fenced in private yard
Yard, but not quite private or fenced... [explain below]
Patio, Balcony, Roof space
No outdoor space
Do you have a pool?
*
Fenced In Pool
Unfenced Pool
No Pool
Describe your outdoor area.
Size, street-facing or neighboring homes with dogs, ground material, etc.
What best describes the areas around your home, building, neighborhood? Check any that apply.
*
Some dogs need quiet areas while others can handle more stimulation
Very Quiet
Some foot traffic but I can avoid dogs, people, cars
I need to pass dogs to exit my building
I live off a busy street
My neighborhood has a lot of unavoidable stimulation
How many hours a day will your dog be left alone? Please describe / give details if your schedule is variable. PLEASE DESCRIBE YOUR NORMAL LIFE SCHEDULE ONCE THE COVID-19 ISOLATION/LOCKDOWN IS OVER.
*
Where will your dog be sleeping at night?
*
What kind of activities are you interested in doing with your dog? Please list/describe.
*
What is your experience with dogs?
*
This is my first dog
I grew up with dogs, but this will be my first as an adult
I've had dogs in the past
I currently have a dog/dogs (describe below)
If you currently have a dog / dogs, please describe (age, size, breed, energy level, social skills with other dogs etc.).
Are your current dogs spayed / neutered?
Yes
No
If No, describe why the dog is not altered
If you currently have other animals or pets, please describe.
If you had dogs in the past, please describe.
Have you ever had a pet with MEDICAL or BEHAVIORAL issues?
Yes
No
If so, WHAT did you do to resolve them? Please give details.
Have you ever had to take a dog to the shelter or given it away?
Yes
No
If so, why?
Anything else you’d like to share with us? The more info you can give us about your dog experience and what kind of dog you are looking for, the better.
If you are interested in a particular dog but it’s not available anymore or may not be a good fit, would you be open to other suggestions that we think may fit your lifestyle?
Yes
No
Please confirm that you are thinking long-term and are able to care for a dog and all its needs (daily exercise, stimulation, veterinary care, companionship, etc.)
Yes, I Confirm
No, I Can Not Confirm This