Canine Adoption Survey

Name

Email Address

Street Address

City

State

Zip

Cell Phone

Home Phone

Other Phone

This pet is meant to be a gift or will be for someone other than myself This pet is meant to be a gift or will be for someone other than myself

Tell us about the members of your household (e.g., number of adults, seniors, and/or young children)

Tell us about pets at home (e.g. number of/age(s) of dogs, cats, other animals living in the home)

Please describe your ideal companion; is there a particular animal at the shelter that you are interested in?

During our conversation we will go over the medical and behavioral history/needs for the pet(s) you are interested in adopting. Please let us know what else you would like to discuss: During our conversation we will go over the medical and behavioral history/needs for the pet(s) you are interested in adopting. Please let us know what else you would like to discuss: Feeding routine Dog training Other training: housebreaking, feline behaviors, leash walking, etc. Grooming Exercise and enrichment Pet proofing your home Veterinary care Introducing resident pets Flea/tick and/or heartworm prevention Ideal toys for your new pet

Is there anything else you'd like to discuss with us pertaining the adoption of your new pet(s)? Let us know here!

I understand that I do not need to receive a response, and that this survey doesn't need to be approved before visiting the adoption center I understand that I do not need to receive a response, and that this survey doesn't need to be approved before visiting the adoption center I understand

I acknowledge that submitting a survey does not put any animal on hold, or prioritize meeting an animal before someone else I acknowledge that submitting a survey does not put any animal on hold, or prioritize meeting an animal before someone else I understand