What pets do you currently have?
1. Breed
Male
Female
Age
Spayed or Neutered?
Yes
No
Indoor or Outdoor?
Indoor
Outdoor
Both
Current on Vaccinations?
Yes
No
Name
2. Breed
Male
Female
Age
Spayed or Neutered?
Yes
No
Indoor or Outdoor?
Indoor
Outdoor
Both
Current on Vaccinations?
Yes
No
Name
If you don't have a dog or cat now, what dogs/cats have you had in your adult life?
1. Breed
Male
Female
Age
Spayed or Neutered?
Yes
No
Indoor or Outdoor?
Indoor
Outdoor
Both
2. Breed
Male
Female
Age
Spayed or Neutered?
Yes
No
Indoor or Outdoor?
Indoor
Outdoor
Both
What happened to the pets you no longer have?
Have you turned a dog you owned into a shelter?
Yes
No
Please Explain
Have you ever had a pet euthanized?
Yes
No
Please Explain
Will your current pets adjust to a new dog in the house?
How many adults are there in your family?
How many children are there in your family?
How old are the children?
How do your children behave around animals? Please be very specific
Does any member in your household have allergies to dogs?
How many hours each day will the dog be without human companionship?
Do you live in:
House
Apartment
Condominium
Mobile Home
Other:
Do you own or rent?
Own
Rent
How long at address?
Are there any pet restrictions?
Yes
No
Please Explain
Are you willing to have a SCDR member visit your home before and after adoption?
Yes
No
If you rent, a letter of permission from your landlord will be required prior to adoption.
Name of Landlord
Landlord's Address
City, State,Zip
Landlord's Phone
Size of yard?
Is it Completely fenced?
Yes
No
Fence Height?
Fence type?
If you do not have a fence, how will you contain the
dog on your property?
Do you have a dog door?
Yes
No
Do you have a dog kennel?
Yes
No
What type?
Are there times when the dog will be tied up?
Yes
No
If yes, when & how
Will the dog spend any time in the garage or basement?
What kind of accommodations do you have for the dog in
the hot/cold weather? Please explain in detail .
Where will your new dog be kept during the day? At Night?
If you drive a pick-up truck, will you allow the dog to ride in the back?
Yes
No
What will you do with the dog if you need to travel (vacation,
business, etc.)?
Do you own or have you used a crate?
Type of Crate?
Plastic
Metal
Both
Do you have a pool?
Yes
No
Do you have stairs in your home?
Yes
No
How many?
The following questions need to be considered carefully.
This will help you determine if you and your family are really ready for
a dog.
Is there any aspect of your home that a puppy/dog could affect adversely such as white carpet, antiques, etc.?
Yes
No
What aspect of a dog is most important to you?
Appearance
Agility
Non-Shedding Coat
Quick Obedience
Friendly Attitude
Adaptability
Other:
What are some traits that you do not like?
Drooling
Odor
Jumping
Chewing
Shedding
Digging
Barking
Other:
Temperament desired?
Natural Leader
Follower
Friendly
Aloof
Out-Going
Demands Attention
Other:
Activity Level:
High
Medium
Low
Some rescued dogs have pre-existing health conditions
that may require further care by the adopter. An example would be allergies
or hip displasia. Would you adopt a dog that has health problems or
special needs?
Yes
No
Are you aware of the annual costs of maintaining a healthy
dog? Yearly vaccines can be $80.00 or more. There is also heartworm preventative,
flea control, dental care, food, accessories, as well as many unforseen
items/circumstances. Are you prepared to meet these requirements?
Yes
No
how much are you willing to spend on medical bills for your dog?
up to $100.00
up to $500.00
up to $1000.00
Whatever it takes
What would you do if the vet bills exceeded the amount you selected
above?
Dogs vary in how much leadership they require.
Some dogs are natural leaders. They are bold or stubborn.
They will take advantage of any mistakes that you may make or any indulgence.
You really have to work hard to convince them that you are the boss.
Would you feel comfortable in the leadership role if needed?
Yes
No
How would you reinforce your leadership role with the dog?
Ever train in obedience?
Yes
No
If you new dog/puppy is not housebroken, what method will you use to train him/her?
How would you encourage and reinforce your dog's appropriate ("good") behavior?
How would you prevent and manage your dog's inappropriate ("not so good") behavior?
Are you willing to train in obedience?
Yes
No
What dog food do you use?
How Often?
Wet or Dry?
Do you use Heartworm Preventative?
Yes
No
What kind?
Have you ever bred a litter?
Yes
No
Have you ever adopted/rescued a dog/cat before?
Yes
No
From who? (Name and Number)
Do all parties (if more than 1 adult in the house) want a dog?
Yes
No
Adopted pets need an adjustment time. Are you willing to give the
new dog at least one month trial to ensure proper adjustment to his/her
new environemnt?
Yes
No
In your opinion, what would be a valid reason for
not keeping the dog?
Are you willing to take responsibility for this dog for
the next ten to fifteen years?
Yes
No
Are you willing to travel to pick up the dog?
Yes
No
How far?
Many Dalmatians are rescued through the efforts of foster
families. Would you be interested in fostering a Dalmatian in the future?
Yes
No
For how long?