LAST NAME: / FIRST NAME: / DRIVERS LICENSE #:
ADDRESS: / CITY: / ZIP:
EMAIL: / HOME PHONE: / CELL PHONE:
Moonshine has demonstrated hypervigilance and generalized reactivity, both at Berkeley Humane and in his previous home. Meaning, he is prone to begin barking at dogs, strangers, unexpected noises, etc. Through structured handling and a quiet housing area, his reactivity has decreased significantly. This consistent behavior work must continue in his new home to prevent his behavioral issues from resurfacing. It is to be expected that he should not be taken for walks in public areas during the first several weeks following his adoption.
With Moonshine’s adoption, a free behavior and training consult will be provided. At this point, a projected timeline regarding when he may be ready for walks will be estimated for his adopter.
1 / How did you hear about Moonshine?
2 / Have youcared for a dog before? / Yes / No
3 / What interests you in Moonshine specifically?
4 / What is your current housing situation? / Rent / Own / Live with Parents
5 / Where will Moonshine predominantly live? / Inside / Outside / Both
6 / When was the last time you had a dog (if you have had a dog previously? / Currently / 1 year / 2-10 years ago / 10+ years
7 / Who will Moonshine live with in your home? / Adults/Seniors / Teenagers / Children / Infants
8 / What other animals will Moonshine live with in your home? / Dogs / Indoor Cats / Outdoor Cats / Other:
9 / How many hours a day will Moonshinebe alone?
10 / How would you describe the activity level of your home?
Do you plan on bringing Moonshine to dog parks? / Very Quiet / Relaxed / Active / Very Active
11 / Do you want Moonshine primarily for companionship? / Yes / No
12 / How much training are you interested in doing with Moonshine? / A lot of training / Some training / No training
13 / Do you plan to enroll Moonshine in Behavior and Training Classes? / Yes / No
14 / Each year, what do you estimate the cost of caring for your dog could be?
(food, leashes, medical care, toys, supplies, etc.) / $
15 / Who will you ask to care for Moonshineif something should happen to you?
16 / What happened to your previous dog(s) if you’ve had any?
17 / Do you have experience in working with or caring for reactive dogs? If yes, please describe.
18 / Do you have experience in working or caring for dogs with other behavioral needs? If yes, please describe.
19 / Are you able to commit to keeping Moonshine predominantly indoors for the first weeks or months after adoption? / Yes / No
20 / Do you have dog training credentials? If yes, please describe.
21 / To accept a gift of free pet insurance, you must consent for Pethealth, Inc. and its affiliates to contact you through email. Do you consent to be contacted by email about a gift of free pet insurance? / Yes / No
22 / Any other pertinent info you’d like to share?
Thank you for your interest in Moonshine! Our Pet Program Manager will contact you soon to schedule the next step in the adoptions process.