Pet ownership is a serious commitment that the entire household needs to
consider and agree to before the animal is adopted. We want to ensure that each
adoptive household is aware of, and willing and able to accept, the physical and
financial responsibilities of pet ownership. Not everyone who desires to own a
pet is ready to properly care for one. This questionnaire will assist both you
and us in determining if your household is prepared to assume the role of
responsible caretaker for a rescued animal. HOMECHECKS ARE REQUIRED but we will
ship by plane. Thank you for filling it out!
To
apply copy and paste this page into a new email and send to turtlegardens@hotmail.com
Are you 21 years of age or older? _____________ (proof may be requested)
Why are you considering adopting a dog? Companionship_____________
Breeding___________ Protection__________
Where would the animal be primarily housed? Inside___ Outside___ About equally
inside and outside___
Where would the animal stay when you are not home?
Loose inside___ Crated or otherwise confined inside___ Loose outside___ Kennel
run/fenced area outside___ Tied/chained outside___ Other
(describe)___________________
Is there a particular dog of ours that you're interested in? _____ If yes, what
is the dog's name?____________________
If no, please note your preferences below so we can let you know when such an
animal becomes available: Purebred, mixed breed or no
preference?_____________________ Male, female, or either? ___________________
Age Range:_________
Animals can be expensive to care for (estimated average annual cost is $750 for
one dog). Are you willing and able to provide adequate food, shelter and medical
care, including yearly checkups and vaccinations, for an adopted animal?
___________
Adopter's Name: ___________________________
Other Adult(s) at Residence:_________________________
Street Address: _________________________________________
City/State/Zip: __________________________________________
Telephone numbers: Home: _______________________
Work:___________________________
Number of children living in the house:_________________ Ages of the
children_______________ Do they live with you full time?____
Do other children visit? ______ If yes, what are their ages? _____________ How
often do they visit?______________________
Does anyone in your household have allergies to animals?___ If yes, to what
kinds of animals?___________________
Does your entire household know that you are considering adopting a pet?__ If
no, why not? ___________________________________
Household setting: __Rural __Suburban __Urban
Do you live in a house__ apartment__ mobile home___ townhouse___
Other________________________________
Do you own? If you rent, you MUST provide proof of permission to have a dog on
the premises
If renting, landlord's name and telephone number:
___________________________________________
Describe your yard: fenced___ kennel run___ no fence___ other(describe)______________________________
If fenced or kennel run, describe material used: chain-link___ wood___
other(describe)______________________
If fenced, height of fence and approximate size of fenced-in
area______________________________________
If fenced, number of gates:_______ Are the gates always securely latched and/or
locked?____________
If the animal is outside other than for supervised activities, describe what
shelter would be available for it: Shed___ Doghouse___ Covered area (porch,
etc.)___ Shade trees___
Other (explain)_________________________
What problems would make you return an animal?
barking___ housebreaking___ chewing___ jumping up___ shyness/other fears___
shedding___ digging___ scratching or climbing on furniture___ other(explain)_______________________
or none, I am committed to working with the animal to correct any of these and
most other problems___
To help resolve problems, are you willing to 1) use a crate___ or 2) take an
obedience class___
Under what other possible circumstances would you return the animal:
Move___ new baby___ divorce___ high cost of animal's care___ personal
illness_____ other(describe)___________________________ none that I know of___
Describe your home's activity level: Busy active/noisy; moderate comings/goings;
or quiet occasional guests_______
Do you feel that a pet should be spayed/neutered? _______ If no, why
not?_______________________________
Approximately how many hours each day would the animal be left alone?
________________
Please list all animals that you presently own (other than fish, rodents, and
reptiles):
Type of Animal/Breed________________________________________
____________________________________________________________
Time Owned__________________________________________________
____________________________________________________________
Age_________________________________________________________
____________________________________________________________
Gender_____________________________________________________
____________________________________________________________
Neutered____________________________________________________
____________________________________________________________
Vaccinated__________________________________________________
____________________________________________________________
Who is responsible for care of the above daily?____________
When you are on vacation? ________________________
Name and telephone number of current veterinarian, if
any:________________________________________________________
____________________________________________________________
Please list animals you previously owned (other than fish, rodents, or reptiles)
and describe what happened to them: 1) ___________________________
2) __________________________
3)____________________________
4)____________________________
Individuals who adopt a TGARS Rescue dog are contacted periodically for an
update to help ensure that the animal successfully adjusts to its new life. If
you adopt a TGARS Rescue dog, do you consent to home visits before and/or after
adoption? ______________
What is the best time to call you at home to check on how the adopted animal is
adjusting?___________________
If at any time an adopter cannot keep the animal, it must be returned to TGARS
Rescue. If the animal is not spayed or neutered at adoption, the adopter is
required to alter the animal and provide a veterinary certification of altering
to TGARS Rescue by the date specified in the adoption contract -- animals
unaltered by the contractual date may be seized. In addition, each pet adoption
is assessed a non-refundable tax-deductible donation, varying by animal to help
pay veterinary/other expenses.
By signing below, I acknowledge that I completely read this questionnaire,
comprehend it fully, know that applying does not ensure approval and that
untruthful answers or failure to comply with the requirements of this
application or the adoption contract can result in the forfeiture of any TGARS
Rescue dog adopted by me.
Signature: ______________________________
Date:________________ Reviewed By: __________________
Please return this form to a TGARS Rescue representative at Turtle Gardens
Animal Rehabilitation Society Rescue, PO Box 230, Topley, BC V0J 2Y0
Questions? Ask a TGARS Rescue representative at
turtlegardens@hotmail.com
or
(250) 696 - 3188