adoption questionnaire

Name *

First Name

Last Name

Phone Number *

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Address *

Please include your apartment / unit number, if applicable.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

3. What kind of yard do you have?

A yard secured with a physical fence

A yard without a physical fence

I do not have a yard

4. Which of the following best describes your household?

I have company over often.

I have company over once in a while.

I rarely have company.

5. Which of the following best describes your lifestyle?

I love being active outdoors (hiking, running) and I’d love to have a dog that can come along.

I like to be out & about but sometimes would leave my dog at home.

I have a laid back lifestyle and like being home, chilling on the couch.

4. Are you prepared for the financial costs of caring for your pet?

Yes, and I am prepared to pay for regular care that could exceed $500/year.

Yes, but I can't imagine it will cost that much.

No, please tell me what annual care costs on average.

6. What is your ability to adjust your schedule and lifestyle to accommodate your pet's social, medical, physical, and mental needs?

I can make a lot of adjustments.

I can make some adjustments.

I must find a pet who can fit my current lifestyle.

10. If your pet developed a new behavioral problem, what would you do?

Check all that apply.

Consult a vet

Consult a trainer

Attempt to work on the problem yourself

Return the pet to the rescue (Rescuzilla)

Other

11. Which of the following might cause you to consider returning your pet?

Check all that apply.

Barking/Whining/Vocalizing

Destructive

Behavioral issues

Doesn't get along with other pets

House training challenges

Medical problems

Requires too much time

Shedding

None of the above

Reference Name *

First Name

Last Name

Reference Phone *

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