HSWC DOG PRE-ADOPTION FORMVET INFORMATION: Please list all vets that you have used and which pets were treated there.
Name: first last
Are you over the age of 21? If not, what is your age?
Address:
Home Phone: Work/Cell Phone:
How long have you lived at this address?
Email:
Is this residence a: Do you:
If rented, does your landlord allow pets?
If yes, how many are you allowed and are there any size restrictions?
Name and phone number of landlord:
Do you care for the children of others on a regular basis?
Do you or your neighbors raise fowl, sheep., or goats
Heve you ever brought an animal to us?
If yes, please explain:
Have you or any other family member been convicted of cruelty to animals or any other animal related charge?
Are you aware that there is no such thing as a free animal? Are you financially prepared to pay for vaccinations, annual exams, de-worming, etc...?
What are your reasons for adopting a dog?
Please describe the temperament and activity level you are looking for in a dog:
When it comes to relating to dogs, do you tend to be more:
Is anyone in the family unsure or nervous of dogs?
How would you describe yourself?
How many adults and children live in your home?
If children, please list ages:
Do you have children that live or visit next door? If yes, ages?
Is anyone in your home allergic to pet hair/dander?
How many dogs, indoor cats, in/out cats, other pets/animals
do you have right now?
I have had dogs and cats as an adult.
What breeds or mixes do you have?
How long have you had them?
Where are they now?
Were all others spayed/neutered and kept up to date on shots?
Finish this sentence:
I need a dog that can tolerate being alone hours a day.When you are at home, where will the dog primarily be kept?
other:
When you are not home, where will the dog be kept?
other:
Where will the dog sleep?
Owning a dog is a lifetime commitment, what provisions would you take/make if you:
Vacation:
Move:
Divorce:
How do you intend to manage fleas and ticks?
What is it about the dog that drew him/her to you?
When outside, how do you intend to keep your dog confined to your property?
Other:
Do you have or are you planning for:
What will your pets day look like:
Do you prefer a dog that :
What bad doggie habits do you think can't be tolerated or would be difficult to manage (you may check more than one):
Other:
Explain how you will discipline the dog:
Are you willing to attend obedience classes if needed?
If the dog is not housetrained, what method will you use to train him/her?
Are you willing to pay for grooming?
Who will the primary caregiver be?
References:
List three (3) personel references and phone numbers (no family members or you vet)Who know your history with your pets:
Ref. 1: Name: Phone:Ref. 2: Name: Phone:Ref.2: Name: Phone:I am Interested in adopting (list dog or dogs):
Are you aware that it is mandatory that ALL animals adopted from this shelter are required to be spayed/neutered within 30 days, unless the animal is already spayed/neutered, or under the age of 5 months (and will be performed at the appropriate age). I permit HSWC to attain my vet information and call my references. All information will be kept confidential.
By clicking "submit", I agree to the above statement and confirm that all information submitted is true and correct.
