Adoption Questionnaire
Thank you for considering a rescue dog in your home.  We are excited to get 
to know more about you and your lifestyle, so please be thoughtful, 
thorough, and accurate in each response so that we can best match each 
animal to their forever home.  For the safety of our dogs we verify all 
information included in the questionnaire, therefore it can take several 
weeks to review. 

*To help expedite the process, please authorize the release of medical 
records with your veterinarian(s) and notify your landlord (if applicable) 
before we call. 

Email address *
Which dogs are you interested in meeting(names)? *
Your answer
First Name *
Your answer
Last Name *
Your answer
Phone *
Your answer
Alternate Phone
Your answer
Are you currently a volunteer with us?
How did you hear about us?
Your answer
Home Address *
Your answer
City and State *
Your answer
Zip Code *
Your answer
Major Cross Streets
Your answer
Employer and Occupation *
Your answer
Work Schedule *
Your answer
Name
Your answer
Co-Applicant Employer and Occupation
Your answer
Work Schedule
Your answer
Adults In Household (name and relationships) *
Your answer
Children that live in or frequent the household (name, relationship, age, and how often they visit) *
Your answer
How will the dog’s life change if a new child (yours, grand child, niece/nephew, etc.) is added to the home? *
Your answer
Do you: *
Do you live in: *
If rental, please provide the landlord's name and phone number:
Your answer
Length of time at current address? *
Your answer
Do you plan on moving in the next 6 months? *
Describe your yard (Pool, grass, gravel, trees, etc?): *
Your answer
What type of water features exist?
Your answer
If applicable, are they surrounded by a fence?
Your answer
Do you have a doggie door? *
If No, do you plan on installing one?
Your answer
How tall is the lowest part of your fence? *
Your answer
What is your fence made out of? *
If you do not have a fence, how will exercise/toilet be handled? *
Your answer
Is your entire household supportive of adopting? *
If not, why? *
Your answer
Is anyone in your home allergic to animals? *
Your answer
When are you ready to adopt? *
Your answer
How long are you willing to wait for the perfect pet? *
Your answer
Are you aware that the dog you are applying for has an adoption donation of $350‐650 and will require a visit to your home? *
What are your plans for this dog? 
How would you describe the physical activity level of your family? *
Required
How would you rate the social activity of your family? *
Required
Who will feed, exercise, and train your new dog?
Your answer
Where will the dog sleep at night? *
Your answer
Where will the dog be kept when no one is at home? *
Your answer
Who will care for the dog in your absence (vacations or emergencies)?  *
Your answer
What are your plans for the dog if you move? *
Your answer
Our adoption contract may state you will need to take your new dog to training classes within 3 months of adoption – can you comply with this request? *
How many dogs do you currently have? *
Are they all spayed and/or neutered? *
If they aren't all spayed and/or neutered, what is the reason?
Your answer
Daily % of time outside *
Your answer
What dog food are you feeding, or plan to feed (please include brand name)? *
Your answer
How many cats do you currently have *
Are they all spayed and/or neutered? *
Are cat vaccinations current? *
If they aren't all spayed and/or neutered, what is the reason?
Your answer
Please provide the age and personality of your pets *
Your answer
What training issues have you dealt with for your pets and how did you handle them?
Your answer
Have you ever re-homed a pet? *
If yes, please explain why and would you have done anything differently?
Your answer
Please provide name of any other Rescue Organizations you have applied to within the past year?
Your answer
Please provide the name, address, and phone for all veterinarians that you have used in the past 5 years *
Your answer
Will you need a veterinarian recommendation?  *
How best would you handle the introduction of your new pet to other animals? *
Your answer
In the past 5 years, have you had any other pets that are no longer with you?  *
If yes, please explain in detail what happened to them *
Your answer
If you have not owned pets in the past 5 years, please explain your pet history. *
Your answer
If your pet needed an expensive medical procedure to provide a longer, happier quality of life, what monetary amount would limit this treatment?  *
Your answer
Please check any of the following special needs you would be willing to accept and handle in a dog?   *
Required
What is your level of experience with this breed?  What research have you done, if you haven’t owned before?  *
Your answer
Why do you want to adopt this particular breed? *
Your answer
Explain the top three things you LOVE about this breed?  *
Your answer
What attributes do you not like about this breed?  *
Your answer
What 3 health issues are common to this breed?  *
Your answer
How do you plan to train the dog?  *
Your answer
What are your thoughts on crate training? *
Your answer
What training issues are you NOT willing to deal with? *
Your answer
What reasons do you find are acceptable to give up YOUR own pet?   *
Your answer
If we don’t have an appropriate match at the time of completing your questionnaire, would you be willing to foster while waiting for your match? (Our foster homes get ‘first dibs’ to adopt the foster dog in their care.)  *
By returning this questionnaire, I am agreeing that the above information is true and correct and understand that this information will be included with my adoption contract.  If found to be untrue at any time, even following adoption, the dog may be reclaimed at no expense to Almost Home Bulldog Rescue.   Further, by applying for the adoption of a dog, I hereby give permission to my Veterinarian, my personal reference, and landlord (if applicable) to disclose information to Almost Home Bulldog Rescue. *
Required
My name is: *
Your answer
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