Telephone Reference Check
Form used to verify Adopter's references.
Email address *
Applicant and Reference Information
Adopter's Name:
Reference Name
Reference Address:
Reference Telephone Number:
How long have you known the Applicant:
How do you know them?
What animals does the Applicant have now?
Describe interactions that you have seen between your friends and their or other people's animals.
Where are these animals now? (If not present in home)
Have they ever had any pets hit by a car or with a serious disease or injury? What were the circumstances and did they receive Veterinary care?
How will others in the home feel about a new dog? Spouse, kids, parents, etc?
Do the animals have free run of the secure yard when no one is home?
Clear selection
Is there a doggy door?
Clear selection
Do you have any concerns with them adopting another animal?
Clear selection
If you left this life and returned as a pet, would you want them to own you?
Clear selection
Status of this Reference:
Clear selection
By typing my name, I attest that I have completed this reference and based upon our conversation, believe that the adopter above should continue based upon the status above.
Date:
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Time:
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