Dog Adoption Application
Name: *
Address: *
Town/City/Postal Code: *
Home Phone: *
Cell Phone:
Email: *
Age Range:
Occupation:
Household Income: *
Name of dog you are interested in adopting:
Why have you chosen this particular dog?
Please explain what you are looking for in a dog.
Are you adopting this dog for you or for someone else? (If for someone else, who?)
What experience do you have as a dog caregiver? Please tell us about dogs you have lived with.
Do you currently live with any pets?
Clear selection
If yes, what type of pets?
Are your pets spayed/neutered?
Clear selection
Do you live in a house, apartment, condominium or townhouse?
Please check 1
House
Apartment
Condo
Townhouse
Do you own or rent your home?
How long have you lived at your current address?
Do you have children? If so, please list their ages.
Is any member of your family allergic to dogs?
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List all members of your household.
Does everyone agree to adopting a dog?
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Who will be primarily responsible for the care of this dog?
Who is your veterinarian?
May we contact them as your reference?
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What is your veterinarian’s phone number?
Do you have dog training experience?
What canine behaviour would you find totally unacceptable?
What canine behaviours or traits are you looking for in an adoptive dog?
Please select all that apply
House trained
Good with other cats
Good with other dogs
Good with children
Other
If you answered other above, please explain
Describe your method of disciplining a dog. You have just come into the kitchen to find the garbage has been knocked over. How do you respond?
You have come home to find your dog has pooped in the house. What do you do?
Are you willing to seek guidance/attend classes with your adopted dog, should you experience behavioural challenges?
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What type of training/ classes would you choose?
Where will your dog primarily live?
Please select one
Inside
Outside
Both
Where will the dog be kept primarily?
Please select one
House
Yard
Garage
Other
How many hours of the day will the dog be alone?
Will the dog have access to the whole house?
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Where will the dog be sleeping?
Do you have a yard?
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If yes, is the yard fenced?
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Do you have a pool?
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If yes, is there a fence around it?
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Describe the exercise that you have in mind for your adopted dog?
What type of food will you be feeding your adopted dog?
Select all that apply
Wet
Dry
List the brands of food here:
How will your dog be cared for if you have to be away from home for an extended period of time on vacation or for business?
Check any of the following reasons why you would give your dog away
Please choose all that apply
Fleas
Getting married or divorced
Allergies
Chews or destroys objects
Too Expensive
Children no longer care for it
Having a baby
Moving where no pets allowed
Other
If you answered other above, please explain:
Approximately how much do you think a dog will cost per year?
Do you know the cost of veterinary emergencies?
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If your dog ran out the door and was hit by a car. The veterinarian can repair the broken leg (and the dog would recover) at a cost of $2500.00 what would you do?
What are your thoughts on Pet Insurance?
Would you have an objection to meeting someone from our agency via Zoom, Skype or FaceTime to conduct a home check prior to the adoption of a dog?
Clear selection
Are you aware that there is an adoption fee of $400.00?
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The adoption fee may include a veterinary exam, spay/neuter, age appropriate vaccines, and a microchip implant. Many of our rescued dogs also have full blood panels run, dental surgeries and other necessary procedures as per their specific needs
Thank you for your time and effort completing the pre adoption questionnaire. One of our volunteers will be in touch shortly by telephone to speak with you about adoption.

If however, we feel the dog you have chosen is not a good match we will reply via email with an explanation; we may suggest considering a different dog.
Thank you!
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