Dog Adoption Matchmaker Form

Dog Adoption Matchmaker Form


Name or ID# of the dog you are interested in:
Name:
Email:
Date:
Home Phone:
Work Phone:
Cell Phone:
Address:
I live in:
How many children live in your home and what ages?
How many adults live in your home?
Do children frequently visit your home?		Yes No
If yes, what ages?
Is anyone in your home allergic to pets?		Yes No
If yes, who?
Is anyone in your home nervous about pets?		Yes No
If yes, who?
I currently:
My home is:
Will you allow an SPCA representative to do a pre-adoption visit to your home?		Yes No
Please list all pets in your household, specifying dog/cat/other:
Are your current pets spayed/neutered?
Do they live indoors or outdoors?
Have you had other dogs or cats in the past five years?		Yes No
If yes, how many dogs?
If yes, how many cats?
Where are they now?
Do you currently have a veterinarian?		Yes No
If so, who?
Approximate vaccination date of current pets
I am looking for (check any that apply)		Puppy Young Adult Adult Senior No Preference
At its ADULT size, my ideal dog would be (check any that apply)		Small (5 - 25lbs.) Medium (25 - 50lbs.) Large (50 - 80lbs.) Extra Large (80+lbs.) No Preference
Please check all reasons for adopting a dog		Companion for self Child's pet Breeding Companion for other animal Gift for someone outside of immediate family Hunting Guard dog for business Watch dog for home Other
If other, please specify
Please describe the energy level you are looking for in your pet?
The dog I adopt should possess these qualities:		Already house trained Already knows basic obedience Doesn't pull on leash Can be left in house unattended Can be walked off leash Doesn't jump up Rarely barks Doesn't dig Low shedding Doesn't chew Likes to play/fetch Doesn't wander Will jog or run with me Gentle with young children Good watch dog Good with strangers Likes other dogs Good with cats Good with livestock Other
If other, please specify
Are you planning on taking your dog to obedience class?
Are you prepared to spend $300 to $500 a year on basic expenses (food/medical) for this pet?		Yes No
Will your dog be kept
How many hours will your dog be left alone each day
Where will your dog be when left alone?
Where will your dog sleep at night?
If other, please specify
I have a:
If unfenced acreage, please specify how much
Under what circumstances would you give this pet up?		Bites/aggressive Difficult to house train Chews/destructive when left alone Requires too much exercise Wanders Moving to "no pets allowed" housing Moving out of state Medical expenses/animal is ill Aggressive with other pets Other
I found my potential new best friend on:
Additional comments