Adoption Questionnaire  


Our Adoption Questionnaire (for puppies) is intended to help us get to know you better and to help you work through many questions that we think every potential adoptive family should think about prior to getting a puppy. It is also our goal that the right puppy and the right placement of each puppy are made by bringing the various requirements of both the puppy and their new owner(s) into perspective, BEFORE an adoption is finalized. We know that you will agree that the puppy’s welfare is our foremost consideration in placement; therefore, this Questionnaire includes both questions about you - as well as your new puppy.

Once we review your Adoption Questionnaire, we will notify you asap if you have been approved for adoption.

If approved, a deposit of $200.00 will be required to confirm your puppy reservation (unless otherwise notified). Please visit our "Fees & Payments" page for deposit details.

Please ensure that all information on your Adoption Questionnaire is accurate as it will be used for all correspondence, receipts, microchipping, insurance documentation, etc.


IN CASE OF CYBER-OOOPS! 
If you do not hear from us within 24 hours, your Questionnaire may not have been received by us.  Please contact us through our email or you can give me a quick call. 



We're currently experiencing technical difficulties with our Adoption Questionnaire.  
If you do not receive a response from us within 24 hours,
please email us:  wildrosekennels@xplornet.ca  
Thanks much!

PART 1: ALL ABOUT YOU

This section is intended to help us get to know you better. All information will be kept confidential and will be used by our kennel only. Please ensure all info is current as it will be used for kennel documentation and correspondence.

Todays Date*

Your Name(s)*

Mailing Address*

City*

Province*

Postal Code*

Home Phone(s)*

Cell Phone(s)*

Business Phone

Email Address*

Deposit of $200 (once you are approved for adoption)*

1. How did you hear about us?*

2. What sort of research have you done prior to contacting us?*

3. Have you ever owned a dog before? If yes, when and what breed(s)?*

4. Have any of your pets died? If yes, when and what were the circumstances?*

5. Have you ever taken a pet to the pound or SPCA? If yes, when and why?*

6. Where do you live?*

7. Occupation of adult(s) in home:*

8. Describe your activity level (ie: couch potatoe / jogger):*

9. Do you presently have other pets in the home? If yes, please describe:*

10. Where will your pup be during the day?*

11. Where will your pup be during the night?*

12. Will you crate train your pup? *

13. Do you have a fenced yard with outdoor shelter/pen from rain and sun etc.*

14. Do you agree to NEVER leave your dog tied up?*

15. Pups should not be left alone for extended periods of time. If you will be away, what arrangements will you make for your pup?*

16. Are there children in your home? If yes, how many and what ages?*

17. Does anyone in your family have allergies to dogs? If yes, describe (ie. sniffles, medication needed):*

18. Do you agree to SPAY or NEUTER your pup by 6 months of age?*

19. Will you read a dog training book or participate in professional dog training?*

20. Your dog will be dependant on you from the moment they come home. Have you considered the time commitment and work involved in having a dog and do you believe that you are able and ready to provide a forever home for a dog?*

SECTION 2: ALL ABOUT YOUR PUPPY

This section is intended to help us place the right puppy in the right home prior to adoption. Each puppy is unique and will grow into a unique adult. When pups are 5 weeks old, they will be evaluated in regards to both coat and temperament. Besides the cute factor, think about what personality traits will best suit your family lifestyle. The well being of each puppy is our top priority!

1. What breed of puppy are you interested in?*

2. What kind of coat do you prefer?*

3. What sex do you prefer your puppy to be?*

4. What colour do you prefer your puppy to be?*

5. What activity level would you prefer your puppy to have?*

6. Check the qualities that you are looking for in your pup?

Outgoing
Reserved
Confident / Leadership
Submissive / Follower
Ability to fetch and retrieve
Eager to play, play, play!
Social with people and animals
Faithful
Adaptable to new situations
Sensitive
Cuddler
Loner - doesn't mind being alone
Gentle
Protective

7. Check the elements in your environment that your pup will regularly be exposed to:

Small children
Elderly
Other pets in your home
Urban noise
Folks with physical or other challenges
Your work place
Overnight adventures like camping etc.
Sports competitions like agility or frisbee etc.
SERVICE DOG

8. When would you prefer to get your puppy?*

9. Do you have any questions or comments?

Please enter the phrase as it is shown in the box above.