Whi
ch of the following problems would be a serious problem for you?
Excessive barking, digging, jumping, not getting along with cats, not getting along with other dogs, not
good with children, not housetrained, too active, not playful with other animals, not playful with
children, not good being left alone, difficult to walk on a leash, too big, too much shedding
Other:___________________________________________________________________________
How many hours per day will the dog be left alone? _______________________
Where will he/she be kept when alone? ____________________________________________________
Where will the dog sleep at night? __________________________
Will there ever be times the dog is tied? _____________________ If yes, when? ___________________
When you go on vacation/travel, who will care for the dog? ____________________________________
How often and what type of exercise will you give your dog?
_____________________________________________________________________________________
Are you interested in a puppy or adult? _________________________________
If puppy, would this be your first puppy? Yes or No
Is this your first dog? Yes or no
What were your previous dogs, if any? _____________________________________________________
Do you have cats? Yes or No How many?__________________
Have you ever had a puppy contract the Parvo virus? Yes or No
If yes, Are you still living where you had the dog with parvo? Yes or No
How long has it been since the dog contracted parvo? ____________________________________
Did the dog survive? Yes or No
Do you currently have any animals? Yes or no
If yes,
What type? _______________________Breed of current dogs: _________________________________
Are your current dogs Fixed? Yes or No
Are they current on vaccines? (DHPP and Rabies) ___________________________________________
What are the ages of your current dogs? __________________________________________________
Name of your veterinarian? _________________________________ City/Town___________________
Have you ever adopted from a shelter/rescue? Yes or No
If so, What rescue organization? _________________________________________________________
