Adoption Questionnaire

We reserve the right to refuse any adoption that we feel will not suit the dog’s/puppy’s requirements. Please complete the questionnaire for adoption as completely as possible. Dogs/puppies are fun, loving, playful, & a lot of work. Please be sure that you can make a commitment to the care of the dog/puppy before you decide to adopt one.

* Required fields
Name *
E-mail Address *
City *
Zip Code *
Occupation *
Phone Number (Home) *
Cell phone number *
Work Number
Name of dog(s) you are interested in. *
Why do you want to adopt a rescue dog? *
If applying for a herding breed (For example...Cattle Dog, Aussie, Border Collie, or a mix of any of these breeds) please tell us about your experience with herding breeds.
How many adults are in your household, including yourself? *
Names of adults in household, ages, and relationship to you? *
How many children (under 18)? Please list their ages... *
If there are no children, do you expect this to change during the lifetime of the pet? *
Do you often have people visiting your home? *
Do you have children visiting on a regular basis? *
Who will be responsible for feeding, housebreaking, and training? *
Is every member of the family in agreement to adopt this pet? *
Does any member of your family have allergies or asthma? *
If yes, what type?
Is someone home during the day? *
If yes, who?
How long will your pet be alone on a regular day? *
When I am home this pet will be kept? *
When I am not home this pet will be kept? *
Do you have a doggie door? *
If not, will you install one?
Where will this pet sleep (be specific)? *
Do you live in a: *
Do you own or rent? *
If you rent, what is the name and number of your landlord?
If you had to suddenly relocate or had other drastic lifestyle changes that made it hard to keep your new pet what would you do with him/her? *
Do you plan to take this dog to obedience class? *
Have you ever taken a dog to obedience class? *
Do you have a completely fenced yard? *
If yes, what type of fencing?
How tall is your fence?
Is there any part of the yard the dog can get out? *
If you do not have a fenced yard how do you plan to keep this pet in your home?
Do you have a pool on your personal property (not a community pool)? *
If yes, is the pool permanently gated?
Will you allow your pet to ride in the open back of a pick-up truck? *
How do you feel about pets living outside? *
How do you feel about chaining or tying a dog? *
Have you ever had a dog/puppy before? *
If so, what type of dog?
How long did you have your dog?
If you no longer have this dog...why?
Have you ever had to give up a pet anytime in your life? *
If yes, where did the dog go?
If you have given up a dog, why?
Please list all the reasons you can think of that you would not be able to keep your adopted dog. PLEASE BE HONEST WITH YOURSELF…there are always legitimate reasons and this will help us match you with a dog that suits your needs. *
What do you intend to feed your dog (Dog food brand if known)? Wet, dry, or both? *
How do you plan to exercise your dog? *
How often do you plan to exercise your dog? *
Is your dog allowed on the furniture? *
Are you willing to adopt a dog that requires housebreaking? *
Do you have a current vet? If so, please provide his/her name, vet office name, phone numer, and city. *
Does your commitment to you new pet include working through issues (ie: fear of strangers, chewing, fear, separation anxiety, walking on leash, etc. *
If your answer above stated "depends on issues", please elaborate...
Is there anything else that you'd like for us to know?
Do you have a pet now? *
What type of pet(s) do you have (excluding caged pets)?
Is your pet good with other animals?
If applicable, are your pet(s) spayed or neutered (altered/fixed)?
If no, please tell us why...
If applicable, where do your current pets sleep?
Please list breed, sex, and age of you current pet(s).

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Thank you for your interest in one of our rescue dogs and for the submission of your application. PLEASE BE ADVISED THAT FILLING OUT THIS QUESTIONNAIRE IS NOT A GUARANTEE OF ADOPTION. Also, please understand that Love 4 Canines reviews adoption questionnaires with the sole intent of making the best long-term companion match possible. Your filling out this questionnaire & your interest in one of our rescue dogs is greatly appreciated! There is a nonrefundable donation fee for all adopted animals.