S. A. S. S.

Shelly’s Angels Saving Strays

Date:

Your full name:

Your Street Address: City, State, Zip:

Home Phone: Work Phone: Cell Phone:

Email Address:

Vet Name and Phone #

Whose name is listed on the veterinary records?

Personal Reference: ______

NameTelephone/#s Best Time To CallRelationship

Personal Reference: ______

NameTelephone/#s Best Time To CallRelationship

What Dog(s) are you interested in adopting?

______

Questionnaire

1. Do you own or rent where you live? If renting, does your landlord allow pets? If so, can you get written proof and give me their number to also confirm?

2. Do you have a fenced in yard, or an electric fence, or will you be leash walking?

3. Do you have other pets, and are they spayed and neutered?

4. Do you have children? Y___ N___ What are the ages of everyone in your Household? ______

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5. Do you or the children have any allergies that would make having to give up the dog later in time?

6. Do you fully understand that we as a rescue have no idea what the exact breed of this dog may be, that we just take a guess, and also ask the vet for their educated guess to what their breed MIGHT be?

7. Do you also understand, that since we do not know the exact breed of this dog, we therefore can not tell if they will be a medium or large sized dog when they get bigger (if they are puppies)

8. When you are not a home during the day or night, where will this dog/puppy be at?

9. Do you also agree that a new dog in a new place takes time to adjust and get use to all new surroundings, and that time should be at LEAST 2 weeks or more?

10. Are you also aware that any new dog or puppy in a new place and new surroundings might have accidents from being scared or nervous...and that it will take some time to adjust to a new routine?

11. Are you aware and ready to take on a dog or puppy that you might have for at LEAST 15 years or more, and have him/her thru illness and divorce, having a baby and moving and so on?

12. We do NOT want to see any of our dogs ever living outside or on a chain in the yard, do you agree with this?

13. Do you understand that we as a rescue can only do the basic type of vetting. This includes but is not limited too, Spay/Neuter, all shots, HW and FECAL testing & prevention for fleas and worms.We cannot know if there are any under lying issues going on, we try to the best of our ability to send you a health dog/puppy, however there are sometimes health problems beyond our control, we rely solely on our vets care and opinion, we can not be held responsible for unforeseen health problems down the road.

14.If the puppy/dog starts to show signs of misbehaving issues, would you be willing to do what ever it took, such as basic obedience classes, or seeking out a trainer before giving up on said puppy/dog?

Please print this form, hand sign, and email back, or fax to 931-268-8159

Thank you.

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Signature Date