Villalobos Rescue Center Adoption Questionnaire

Name (required)

Address (required)

City/State/Zip
(required)

Phone (home)

Phone (work)

ABOUT YOUR POTENTIAL NEW DOG:

 

I am interested in adopting a dog that fits the following profile:

Breed

Gender

Color

Purpose of dog

Age

Indoor or outdoor dog

Where will the dog sleep in bad weather?

How much time will dog spend home alone?

Who will dog be sleeping with?

When you go to work, where will dog stay?

YOUR PAST ANIMAL HISTORY:

Species/Breed          Gender          Altered          Age          Do you still own this dog? If not, why?

FAMILY BACKGROUND

Who else lives in household?

If any children, what ages?

Who in the household works?

Is anyone in the household allergic to dogs?

What is your relationship like with your neighbors?

RESIDENCE BACKGROUND:

Residence

Status

If renting, what name is the lease under?

If renting, may we contact your landlord to verify permission for having a dog?

Are you aware that there are some restrictions with insurance companies that may deny you the ownership of certain breeds of dogs while residing on the property being insured? Because of this and especially if you are renting, we will have to contact the landlord. It's been all too common for us to have dogs returned, because the tenant tried to "get around" the landlord.

Do you have a fenced frontyard?

backyard?

What type of fencing is the front?

How high is the fence?

How high is the gate?

What type of fencing is the back?

How high is the fence?

How high is the gate?

Do you lock/secure your gates?

If yes, with what?

Do you have a pool?

If yes, does a pool person come to clean?

Do you have a gardener?

Does your meter reader have to enter your yard?

MISC BACKGROUND:

If any past or existing dogs, have you ever attended a training class?

If no, would you be willing to attend or even register with ours?

If adoption is successful, would you be willing to attend a FREE dog behavioral seminar or talk to one of our trainers about the DO's and DON'Ts?

Do you already have a veterinarian?

If yes, who?

Under what circumstances would you chain up a dog?

Under what circumstances would you give up a dog?

Why did you choose this particular breed?

Is there anything else you would like to add?

Email address
(required)

We can only adopt out to the following states due to driving limitations: CA. NV. AZ. We have found out that in the past if adoptions don't work out, it makes it almost impossible to get the dog back here to the facility otherwise.