AHBR ADOPTION QUESTIONNAIRE
Almost Home Bulldog Rescue
ADOPTION QUESTIONNAIRE
Please email your completed questionnaire to:
AlmostHomeBulldogRescue.Org
Thank you for considering a rescue dog in your home. We are excited to get to know more about you and your lifestyle, so please be thoughtful, thorough, and accurate in each response so that we can best match each animal to their forever home. For the safety of our dogs we verify all information included in the questionnaire, therefore it can take several weeks to review.
Due to the high volume of responses we receive,
incomplete questionnaires will not be processed.
*To help expedite the process, please authorize the release of medical records with your veterinarian(s) and notify your landlord (if applicable) before we call.
POTENTIAL ADOPTER
Which dogs are you interested in meeting (names)?
Your Info - Primary Applicant
Last Name: First Name: Email Address:
Phone #’s (H) (C) (W)
Home Address: Apt #:
City: State: Zip:
What are you major cross-streets?
Employer: Occupation:
Work schedule/hours:
Co-Applicant Info – Secondary Applicant
Last Name: First Name: Email Address:
Phone #’s (H) (C) (W)
Home Address: Apt #:
City: State: Zip:
What are you major cross-streets?
Employer: Occupation:
Work schedule/hours:
REFERENCES
Provide two references that know you as a pet owner
Name / Relationship / Years Known / Email or Phone #
HOUSEHOLD
Do you: Own Rent Live with a family that owns
Do you live in: House Apt/Condo Mobile Home Other (please describe):
If rental, please provide Landlord’s Name*: Phone number:
Length of time at current address? Do you plan on moving in the next 6 months? Yes No
Describe your yard (Pool, grass, gravel, trees, etc?):
What type of water features exist?
If applicable, are they surrounded by a fence?
Do you have a doggie door? Yes No Do you plan on installing one?
How tall is the lowest part of your fence? What is your fence made out of?
If you do not have a fence, how will exercise/toilet be handled?
Please list names & ages of any children that live in or frequent the home:
Name / Relationship / Age / How often they visitHow will the dog’s life change if a new child (yours, grandkid, niece/nephew, etc.) is added to the home?
Is your entire household supportive of this adoption? Yes No If not, why?
Is anyone in your home allergic to animals?
LIFESTYLE
When are you ready to adopt? How long are you willing to wait for the perfect pet?
Are you aware that the dog you are applying for has an adoption donation of $350-550 and will require a visit to your home? Yes No
What are your plans for this dog?
Pet Guard Hunting Obedience S&R Breed Other
How would you describe the physical activity level of your family?
Very athletic … (frequently hike, camp, jog/run several times a week)
Average … (can be expected to take the dog for a long walk at least once a day)
Couch potato … (dog will probably be getting most of its exercise in the back yard)
How would you rate the social activity of your family?
Very busy ... dog might spend quite a bit of time on its own
Average ... average working family, but dog will spend off-work hours with family
Low ... Would devote their lives to the dogs
Who will feed, exercise, and train your new dog?
Where will the dog sleep at night?
Where will the dog be kept when no one is at home?
Who will care for the dog in your absence (vacations or emergencies)?
What are your plans for the dog if you move?
Our adoption contract may state you will need to take your new dog to training classes within 3 months of adoption – can you comply with this request? Yes No
PETS
Please list all pets currently living in your household:
Name / Breed/Type / Age / Gender / Fixed? / Daily % Time Outside
Can you describe the personality of your pets?
If you have dogs currently, what are you feeding them (please include brand name)?
What training issues have you dealt with for your personal pets and how did you handle them?
Have you ever re-homed a pet? If yes, explain why and would you have done anything differently?
Please provide name of any other Rescue Organizations you have applied to within the past year?
DOG CARE
Please list all of the veterinarians that you have used in the past 5 years*:
Name / Address / Phone
If you do not have a local veterinarian, how do you plan to find one?
Will you need a veterinarian recommendation? Yes No
In the past 5 years, have you had any other pets that are no longer with you? Yes No
If yes, please explain IN DETAIL what happened to them:
If you have not owned pets in the past 5 years, please explain your pet history.
How best would you handle the introduction of your new pet to other animals?
If your pet needed an expensive medical procedure to provide a longer, happier quality of life, what monetary amount would limit this treatment?
Please check any of the following special needs you would be willing to accept and handle in a dog?
Will not accept special needs
Minimal (daily meds, special diet)
Moderate (frequent meds, house training, behavioral issues)
Moderate to severe (epilepsy, food allergies)
Severe (blind, deaf, incontinent)
BULLY KNOW HOW
What is your level of experience with this breed? What research have you done, if you haven’t owned before?
Why do you want to adopt this particular breed?
Explain the top three things you LOVE about this breed?
What attributes do you not like about this breed?
What 3 health issues are common to this breed?
How do you plan to train the dog?
What training issues are you NOT able to deal with?
What are your thoughts on crate training?
What reasons do you find are acceptable to give up YOUR own pet?
If we don’t have an appropriate match at the time of completing your questionnaire, would you be willing to foster while waiting for your match? (Our foster homes get ‘first dibs’ to adopt the foster dog in their care.)
Yes No
By returning this questionnaire, I am agreeing that the above information is true and correct and understand that this information will be included with my adoption contract. If found to be untrue at any time, even following adoption, the dog may be reclaimed at no expense to Almost Home Bulldog Rescue. Further, by applying for the adoption of a dog, I hereby give permission to my Veterinarian, my personal reference, and landlord (if applicable) to disclose information to Almost Home Bulldog Rescue. Agree Disagree
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