*If there is a question that doesn’t apply to you, please enter N/A.
If any, please list the names of any other adult occupants in your household and their relationship to you:
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If any, please list the names and ages of any children in your household:
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Does anyone in the family have a known allergy to the type of animal you wish to adopt?
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If any, please list the type (and breed), age and sex of any current animals living in your household:
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How long have you owned them and how did you obtain them?
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If not, why?
If not, why?
How tall is your fence (if applicable)?
Where will your new adopted pet spend the day? Will they have access to outside facilities? (describe)
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Where will the your new adopted pet spend the night? Where will they sleep? (describe)
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Number of hours (average) your new adopted pet will spend alone?
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If so, please explain and list the address:
Please list all pets you have owned since you turned 18 years old, length of ownership and reason(s) why your ownership ended:
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Describe your level of pet owning experience:
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How did you train your pets in the past?
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Have you ever had a pet that had behavioral issues and/or got into a fight?
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How often did/do you walk your dog?
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Do you use a leash? If so, which kind?
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Have you ever surrendered a pet? If so, why?
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Have you ever had a pet euthanized? If so, why?
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Have you ever lost a pet to an accident?
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How do you discipline your pets and why?
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Veterinarian’s name:
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Clinic Name:
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Clinic Address:
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