You can always press Enter⏎ to continue
dog-face
Welcome
Hi there, please fill out and submit this form.
57
Questions
START
1
Name of dog you want to adopt
Previous
Next
Submit
Press
Enter
2
Adopters name (First and Last Name)
Previous
Next
Submit
Press
Enter
3
Co-adopters name (First and last)
Previous
Next
Submit
Press
Enter
4
Your age
Previous
Next
Submit
Press
Enter
5
Your Employer
Previous
Next
Submit
Press
Enter
6
Co-adopters Employer
Previous
Next
Submit
Press
Enter
7
Address
Street Address, City, Town, Country, Postcode
Previous
Next
Submit
Press
Enter
8
How long have you lived at this address?
Previous
Next
Submit
Press
Enter
9
Your email address
Previous
Next
Submit
Press
Enter
10
Co-Adopters email address
Previous
Next
Submit
Press
Enter
11
Phone Number including area code and country code
Previous
Next
Submit
Press
Enter
12
Names and ages of all permanent residents in your home (Adults and Children)
Previous
Next
Submit
Press
Enter
13
Current pets that live in your home
Previous
Next
Submit
Press
Enter
14
Vet Reference and name of Vet
Previous
Next
Submit
Press
Enter
15
When will you be ready to adopt the Dog?
Previous
Next
Submit
Press
Enter
16
Are you planning to move in the near future?
YES
NO
Previous
Next
Submit
Press
Enter
17
If answered YES where are you moving- City/State
Previous
Next
Submit
Press
Enter
18
Are you going to meet another dog?
YES
NO
Previous
Next
Submit
Press
Enter
19
If you answered YES to the previous question when will this be?
Previous
Next
Submit
Press
Enter
20
Is there anyone in your home allergic to dogs?
YES
NO
Previous
Next
Submit
Press
Enter
21
Does anyone in your home fear dogs?
YES
NO
Previous
Next
Submit
Press
Enter
22
Does anyone in your home smoke?
YES
NO
Previous
Next
Submit
Press
Enter
23
Are you familiar with the dog regulations in your area?
YES
NO
Previous
Next
Submit
Press
Enter
24
What are the regulations?
If you answered NO to the previous question please check your council areas dog regulations
Previous
Next
Submit
Press
Enter
25
Tick the relevant box
I/We live in
Home
Duplex/Twin
Trailer/Condo
Apartment
Farm
Previous
Next
Submit
Press
Enter
26
Do you own or rent your home?
If you rent you must include a letter or statement from your Landlord to say they will allow dogs on the property and show any limitations. f you live in a townhouse or Condo you must show written proof that you are allowed to have a dog there and show any restrictions.
Previous
Next
Submit
Press
Enter
27
Approximate square footage of your house
Less than 800 square feet
800-1000 square feet
1000-1500 square feet
1500-2000 square feet
Over 2000 square feet
Previous
Next
Submit
Press
Enter
28
Do you have a yard?
Vertical fenced yard
Yard with invisible fence
Yard no fence
No yard
Farm area
Previous
Next
Submit
Press
Enter
29
If fenced how high is the fence?
2' high
3' high
4 'high
5' high
6' high
Previous
Next
Submit
Press
Enter
30
Do you work outside the home?
YES
NO
Previous
Next
Submit
Press
Enter
31
Is anyone home during the day?
YES
NO
Previous
Next
Submit
Press
Enter
32
How many hours will the dog be on his/her own?
Please explain
Previous
Next
Submit
Press
Enter
33
Family Members
We would like to speak to all members of the household to confirm that everyone is aware of this application process and wants to have a dog added to the family unit. Please do not submit this application if you are trying to talk someone into "Adopting this dog" or you think once they meet the dog they will want to keep it, or use "Im getting the dog as a birthday present for someone. You are most welcome to email us to discuss the dog but we would like all adults in the home to be involved in that email discussion
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
34
Who would take care of the dog when you go away or in an emergency?
Previous
Next
Submit
Press
Enter
35
Based on the Dogs Bio do you feel pretty confident that you will be likely to adopt this dog upon meeting him or her?
YES
NO
Previous
Next
Submit
Press
Enter
36
If answered NO why is this?
Previous
Next
Submit
Press
Enter
37
If your Dog develops behavioural issues such as chewing, urinating inside, excessive barking are you prepared to deal with this?
Previous
Next
Submit
Press
Enter
38
How much do you think you can reasonably afford and would be willing to spend on your Dog per year (things such as Veterinary care, licensing, Dog Tags, food, crate, pet sitting)?
Previous
Next
Submit
Press
Enter
39
What activity level do you prefer?
Wild and crazy is cool
Leash trained and daily jogging partner
Medium energy, plays and then relaxes a bit
Low energy
A total couch potato
Previous
Next
Submit
Press
Enter
40
Please check all that apply, I want to adopt this dog...
As a family pet
To breed with my other dog
To train and use for hunting
To train for agility
To train as a therapy dog
To train as an assistance dog
To use as a guard dog
For a jogging Hiking Partner
To interact with friends and family
As a gift for a friend
As a companion for my other dog/s
As a companion for my cat/s
As a companion for my child/children
Previous
Next
Submit
Press
Enter
41
My adopted dog will be...
Kept outside most of the time
Kept indoors most of the time
Be left outside when we are at work/away
Be kept inside whilst we are away
Be crated when we are not at home
Have a free reign of the house when we are not at home
Be taken to formal obedience classes
Be trained by me/us
Take frequent car rides with us
Be kept on a lead/cable in the yard
Be mostly interacting with adults
Be frequently interacting with children under eight
Be interacting with older children
Must be housetrained before adoption
Will be housetrained by us if necessary
Be walked more than one mile per day, every day
Will be walked occasionally
Will be attending a formal group training
Be trained without the advice of a trainer
Have private sessions as needed
Be taking frequent car/trips with us
Be boarded when we go on vacation
Stay with family when we go on vacation
Be given away to someone else if we feel it is not a good match
Be turned into a shelter if we cant keep
Be going camping with us
Be going on boat trips with us
Other
Previous
Next
Submit
Press
Enter
42
Please take time to think, be HONEST and tell us what you are absolutely NOT willing to deal with at the time of adoption or at any time during the dogs life...
Housebreaking
Chewing
Jumping
Pulling on leash
Counter surfing
Obedience training
Fear of Women
Fear of Men
Fear of Children
Mouthiness, may sometimes snag your arm, leg or hand
Growling
Barking
Rough play with my dog
High activity level
Food/Toy aggression and not willing to share
Food/toy aggression with other people
Whining/Crying
Blindness
Limited sight
Deafness
Separation anxiety
Diabetes
Special diet
Long term medication
Incontinence/leaking urine
Taking classes with the dog
Has lost a limb
Gets carsick when riding in vehicle
Doesn't know how to climb stairs
Cant climb stairs due to age or Arthritis/health issues
Heart condition
Skin or food allergies
Trimming nails
Yeast on coat or in ears
Ear mites
Fleas
Ticks
Heartworm preventative
Annual heartworm/Lyme combo testing
I will do whatever it takes to help this dog ADJUST and work with a trainer to resolve any training needs
Other
Previous
Next
Submit
Press
Enter
43
In your opinion what would justify returning a pet?
Previous
Next
Submit
Press
Enter
44
In your opinion what is the reasonable time for a dog to adjust to life with you/ your family?
Previous
Next
Submit
Press
Enter
45
How do you plan to integrate this dog into your family?
Previous
Next
Submit
Press
Enter
46
Are you aware of crate training?
YES
NO
Previous
Next
Submit
Press
Enter
47
Have you ever housetrained a dog before?
YES
NO
Previous
Next
Submit
Press
Enter
48
Are you aware that a new environment/a new country is stressful for your pet and they may exhibit uncharacteristic behaviour?
YES
NO
Previous
Next
Submit
Press
Enter
49
Do you plan to take obedience classes with your dog?
YES
NO
Previous
Next
Submit
Press
Enter
50
What type of food do you plan to feed your dog?
Previous
Next
Submit
Press
Enter
51
Grooming, please check all that apply...
We use a professional groomer
We trim nails ourselves at home
We bathe our dogs once a week
We bathe our dogs once a month
We bathe our dogs whenever we feel they need it
We bathe our dogs twice a year
We don't bathe our dog/s
We check ears weekly for yeast or mite infestation
We check coats daily for ticks in summer and fleas in fall
We clean teeth using home methods
We take our dog to the Vet for dentals as required
I/we prefer a dog that doesn't shed
Don't care about shedding
Previous
Next
Submit
Press
Enter
52
What would you do if you discovered after adoption (any time of life) that your vet diagnosed an expensive health condition?
Previous
Next
Submit
Press
Enter
53
Do you plan to get pet insurance?
yes
No
did not know this was available
Other
Previous
Next
Submit
Press
Enter
54
How long have you been looking for a dog?
Previous
Next
Submit
Press
Enter
55
Why do you want to adopt a dog/ or a dog from overseas?
Previous
Next
Submit
Press
Enter
56
Do you have any additional comments, questions or concerns? Anything else that you think is important so we can match you up to a dog?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
57
Please sign (type) you have read and understood all the information above
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
57
See All
Go Back
Submit