Pet's Name you are interested in adopting: ( Or Type - Breed - Color etc.)
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Name
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First Name
Last Name
Age
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Phone
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(###)
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Employer Name
Employer Address
Work Hours
Time at current job:
Spouse/Roommate Name(s):
Age
Employer Name
Work Hours
Time at current job:
How many adults in the household?
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How many children in the household?
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Name(s) and Age(s) of children
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What prompted you to get a new dog?
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List the pet(s) you currently have:
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Are there cat(s):
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What is the biggest challenge you faced regarding your pet(s)?
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If other, please specify.
Please list pets you previously had:
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Have you taken a pet to obedience class or consulted a behaviorist?
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If Yes, Please Explain Reason & Outcome:
Who will be responsible for the care of the pet?
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What accommodations will you make to assist your pet during the initial adjustment to your home?
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Have you researched the care and responsibility involved for the pet of interest? If so, please share Book Names, Internet Sites, etc.
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What brands of food do you plan to feed your new pet?
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What types of treats will you feed your new pet?
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Where will you keep your new pet?
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Do you plan to use a cage?
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What type and size of cage will you use?
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Do you have a Landlord?
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Do you have a pet-sitter?
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Do you have any animal allergies?
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Do you have a Veterinarian?
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If yes, please provide name, location, and phone number:
How old do you think the pet of interest will live to be?
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When will your pet be inside?
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Where in the home will your pet be allowed?
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What type of behavior will you not tolerate?
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How do you think you might handle such behavior?
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What is your biggest concern about adopting a new pet?
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When will you be spending the majority of time with your new pet?
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What are you looking forward to the most about adopting a new pet?
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There may be difficulties that arise bringing a new pet into your home. Under what circumstances would you consider returning your pet?
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If other, please specify:
In the future, why would you consider not keeping your pet?
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If other, please specify:
Would you agree to a home visit if you were to adopt from us?
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What are your feelings about this request?
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Email
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Date Submitting Form
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