Wyandotte Animal Control

Dog Adoption Survey

Wyandotte Animal Control Adoption Committee reviews this application before releasing any animal to a new home. The following questions will help us to place the animals into homes that match both the adopter’s and animal’s needs. Wyandotte Animal Control reserves the right to decline the adoption of any animal for any reason if it feels the home will not be a good match.

Name
Address
City and Zip
Home Phone / Cell Phone
E-Mail Address

Please print clearly and answer all questions. Please answer honestly; there is no right or wrong answers.

Dog/Puppy Name:______Intake Number______

1) Do you live in (select one): House___ Apartment___ Condo/Townhome___ Other___

2) Do you: Own____ Rent/Lease____ Name of Complex & Office Phone #

3) Are you planning to move in the next six months? Yes_____ No _____

4) What will happen to this dog if you move unexpectedly?

5) What will happen to this dog when you go on vacation or in case of an emergency?

6) How many hours during the average day will your dog be without a human?______

7) Do you want this dog to be (select one): Inside only____ Outside only____ Both____

8) Where will this dog be kept during the day? ______

Night? ______When you’re not home? ______

9) Does your home have a dog door? Yes____ No_____

10) Do you have a fenced-in back yard? Yes ____ No _____

If your yard is fenced be sure to check for gaps and weaknesses in the fencing before bringing your dog home.

If you are adopting a large dog consider if your fence is tall enough (6 ft).

11) Does your gate have a lock? Yes___ No____ If not could one be put on? ______

(Gates should always be locked so the dog cannot be let loose by neighborhood kids or utility service people.)

12) If there is no fenced yard how will you exercise the dog?

13) If the yard is not fenced who will walk the dog and how often will you take the dog out?

14) Why do you want this animal? (Please circle one or more of the following)

Companion Guard Dog Companion for the Kids Watch Dog Hunting Dog

Companion for Other Dog/Puppy For Breeding Gift

15) Please list below all the people your dog will be living with (including yourself):

Name Age Relationship to prospective adopter

______APPLICANT______

______

______

______

16) Did your entire family agree on the adoption of this one dog? Yes____ No _____

17) Will the whole family share in the care of this dog? Yes_____ No _____

18) Is there any member of your household who is allergic to dogs? Yes ____ No ____

19) Are there any children that visit your home frequently? Yes _____ No_____

20) Do you have any other pets living with you now? Yes___ No___ If Yes, please list below:

Type Breed S/N Owned for how long?

______

______

______

21) Have you had pets in the past? Yes____ No_____ If Yes, please list below:

Type Breed S/N Where is pet now?

______

______

______

22) Do you have a regular veterinarian? Yes _____ No ______

Clinic name, address, and phone number ______

23) How often do you feel a dog should see a veterinarian?

Are you aware of the financial commitment and responsibilities of owning a companion

animal? (Approximately $400 a year for food, vaccinations, licensing, etc., not including

emergency medical care.) Yes No

24)Are you willing to spend this much or more? Yes No

25) What do you know about heartworms?

What would you do if your dog develops a problem with:

Digging:

Barking:

Chewing:

Separation Anxiety:

Aggression:

I certify that the above information is true and understand that false information may result in nullifying this adoption.

Applicant’s Signature ______Date______

WE RESERVE THE RIGHT TO REFUSE AN ADOPTION!

Thank you for completing the Dog Adoption Application. Please return it to an adoption counselor so that we may review it with you. The entire adoption procedure usually takes about a week.