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Thank you for your interest in adopting a rescue dog/puppy from Petstreet Good Hearts! The following information is required so that we can assist you in the selection of your new dog/puppy.
* Indicates required question
Name
*
Your answer
Occupation
*
Your answer
Address
*
Your answer
Phone number
Your answer
Email:
*
Your answer
Children (with ages)
Your answer
List any additional people in household
Your answer
Who will be responsible for the dog's care (feeding, cleaning litterbox, aking to vet, etc)?*
Your answer
Has anyone in your household experienced allergies or asthma?*
Yes
No
Clear selection
Are you prepared to care for this dog for 10-15 years?*
Yes
No
Clear selection
Who will provide for your pet in the event that you become ill or unable to care for him/her?*
Your answer
Why are you looking to adopt a dog? (check all that apply)*
Companion for you/spouse
Companion for children
Companion for pet
Replace lost/deceased dog
Gift for...
Other (please explain)...
Other
Gift for
Your answer
Other (please explain)*
Your answer
Is your home a(n):*
House
Apartment
Condo
Other
Do you rent or own your home?*
Rent
Own
Where will your dog sleep at night?*
Your answer
How many hours a day will your dog be left alone?
Your answer
Where will (s)he be left alone?
Your answer
How often will your dog be exercised?*
Your answer
Will this dog be your first pet?*
Your answer
Do you have any other pets?
Your answer
Please list pets you've previously owned
Your answer
What happened to pets previously owned?
Your answer
If deceased, what was the cause of death?
Your answer
Do you have a Veterinarian?*
yes
no
Clear selection
If you currently have dogs/cats, are they spayed/neutered?
yes
no
Clear selection
Are their vaccinations current?
yes
no
Clear selection
How often does your pet visit the veterinarian?
Your answer
When was their last visit to the veterinarian?
MM
/
DD
/
YYYY
Are you prepared to cover any vet expenses that you may incur throughout your dog's life?*
Your answer
If yes, is there a limit?
Yes
No
Maybe
Clear selection
What traits are you looking for in a dog?
Your answer
Are there any behaviors that would be unacceptable to you?
Your answer
How do you plan on training your dog?
Your answer
Would you be willing to hire a professional trainer to help with any major behavioral issue?
Your answer
What amount of time do you think is reasonable for your dog to adjust to you and your home?*
Your answer
What will you do with your pet if you move to a new home that does not allow pets?
Your answer
Under what circumstances would you not be able to keep this dog? (please check all that apply)
Pregnancy/Baby
Divorce/Separation
Spouse/child is allergic
Needs too much attention
Job change/loss
Dog bites people
Destroys household items
Behavioral problems
Expensive vet bills
Conflicts with other pets
Dog is untrainable
Needs special diet
Dog becomes disabled
Requires daily treatment
Other
If you have to give up this dog for any of the above checked reasons, what will you do with the dog?
Your answer
Were you ever in a situation where you were not able to keep a pet?*
Yes
No
Maybe
Clear selection
Are you willing to have an Petstreet representative visit your home?*
Yes
No
Maybe
Clear selection
I certify that all of the above information is true and accurate. I understand that if I adopt a pet from Petstreet Good Hearts, this document will become part of the adoption record.
Yes
No
Today's Date*
MM
/
DD
/
YYYY
Dog Preference*
Your answer
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