Henry's House Adoption Questionnaire
Thank you for taking the time to fill out this questionnaire. Please understand that the dog you are inquiring about has been our family member from the moment they came under our care. We only want what is best for them. The purpose of this application is to learn a little about your family and home so that we can ensure the best possible match for both you and our rescue dog. Our primary concern is placing them in a compatible home with a family that will give them a lifetime commitment of love and proper care.

Please note that completing this application does not bind you to adopt one of our dogs, nor does it guarantee that we will place one of our dogs in your home. Please answer the questions honestly and thoroughly. We at Henry’s House value the privacy of our adopters. The information collected during our adoption process is used to ensure the best home for dogs under our care. Your information is for our files only and will not be released to any outside parties.

We reserve the right to refuse adoption to anyone for any reason. A representative of our group will conduct a home visit prior to an adoption. Our group has the right to reclaim an animal following an adoption if unsuitable home conditions, evidence of neglect, abuse or other mistreatment of the dog are found on said visit.

Our Adoption Process:
1. Adoption Questionnaire
2. Meet and Greet and Start of Adoption Contract
3. Home Check and Completion of Adoption Contract

IN ORDER TO BE CONSIDERED, YOU MUST:
* Be 18 years of age or older.
* Have identification showing your present address.
* Have the knowledge and consent of your landlord.
* Be able and willing to spend the time and money necessary to provide training, medical treatment, and proper care for a pet for the entire life of that animal.
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Email *
Name: *
Occupation: *
Do you have any children or are there children who live in or frequent your home? If yes, what are their names and ages? *
Do you own or rent? If you rent, please provide your landlord's name and telephone number. *
What pets do you currently have in your household? For each, please give us the following information: Type (dog, cat, etc.), age, whether the animal is altered, and whether it is an indoor pet, outdoor pet, or both. *
Other than the animals previously described, what other pets have you had in the last five years? For each, please tell us the type of animal and what happened to him or her. *
Briefly describe your experience with animals: *
Your veterinarian's name, hospital, city, and phone number: *
Is there a dog or pet limit in your city or county? If yes, what is the limit? *
Does anyone in your home have pet allergies? *
Is the whole family in agreement with adopting a rescue pet? If not, who isn't and what are their reasons? *
You would like a dog for: *
Required
What will you do if your new dog chews your belongings or shows other destructive behavior? *
How will your dog be confined to your property? *
Required
How much exercise do you plan to give your dog? *
Is there a specific dog you are interested in adopting from us? If yes, please indicate their name and tell us why this particular dog. If no, please tell us if there is anything specific you are looking for. *
How many hours will they spend alone each day? *
Will you crate your dog when not at home? *
Where will your pet be kept during the day? At night? *
How long do you feel a dog should be given for an adjustment period? *
Are you willing to work with a new pet on any issues he or she may have? *
What behaviors would be unacceptable to you? *
What actions would you take to correct these behaviors? *
Excluding your death, what conditions or circumstances would cause you to give up an animal? *
Questions or comments:
Best method/time to contact you: *
Thank you for taking the time to answer our questions. We hope that by going through this process we will reduce the chance of an inappropriate match for both you and our dogs. If you have any comments regarding this adoption application or our adoption process, please feel free to let us know as we are always looking for ways to improve! Again, thank you for considering a rescue dog and saving a life. *Note: Submission of this questionnaire and a meet and greet do not guarantee adoption.
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