Dog Adoption Questionnaire

Please complete the following form. If you don’t receive an answer in 24 hours contact

Fields marked with * are required.

Date you are physically able to bring a dog home:*


Street Address*



Cell Phone:
Work Phone:
Home Phone:


Name of animal applying for:

Name of animal’s adoption coordinator:

Size of dog (when full grown) I’m looking for:
less than 30 lbs31-50 lbs51-75 lbsover 75 lbsopen

Gender of dog I’m looking for:
malefemaleI’m open to either gender

Age of dog I’m looking for:
8 weeks -6 mos6 mos-1 yr1-6 yrs6 yrs+open

I would consider adopting
blind animaldeaf animalamputeeanimal with ongoing medical needs

Type of dog I’m looking for:
low-sheddingpurebredmix breedother

I live in:
house/townhouse I ownhouse/townhouse I rentapartment/condo I ownapartment/condo I rent

Name, phone & e-mail of landlord:

Name and ages of all individuals living at address:

How many hours daily will pet be alone?

Where my pet will stay when I’m not at home:
crateloose in housegated areain yarddoggy daycarewith friends or familyother
**(We recognize this may change as your dog adapts. Please list all you will utilize/consider during your dog’s life.)

Have other pets currently? If yes, please list names, types and ages:

If past pets, please list names, types and ages:

Name of Vet you use now and used with past pets*:

Phone of Vet* (must provide phone or we will not consider application):

I would like a dog who is:
very activeactivecalm and mellowgood with catsdog park materialgood with senior citizensgood with kids under 8 yrsgood with kids over 8 yrsgood with urban noisesother

I can/will commit to:
no trainingsome traininga lot of training

I have or will plan to install/use the following:
no fencechain link fencewood fenceelectric fencedoggy door
(if you currently have a fence, please indicate height):

I would like more info on:
healthy diettraininghousebreaking cratingother

How much do you plan to spend on your pet annually:

Reasons I would consider giving up my pet:
financialbehaviormovinganimal medical issuesallergieskidsdeploymentpersonal medical issuesother

I certify that I have never been convicted of animal cruelty, neglect or abandonment.

Yes, I am aware that my adoption fee is non-refundable.
*(Exceptions will be considered only on a case by case basis.)

Additional information that will assist in your search for a dog: