Dog Adoption Test

Personal Information

First Name *

Last Name *

Phone (Home)

Phone (Mobile) *

Email Address *

Address

Address (Line 1) *

Address (Line 2)

City *

State / Province / Region *

Postal / Zip Code *

Country *

How did you hear about this adoptable dog? Check all that apply. *

Facebook

Poster

Community Event

Referral Friend

Pet Finder / Adopt-a-pet

Instagram

Web Search

Adopt-a-thon

Other

Please provide the name of the dog you are interested in adopting: *

Select from the following to tell us why you would like to adopt a dog. *

Companion to a person

Companion to a pet

For a child

As a therapy dog

As a gift

For protection

As a livestock guardian

Other

Please tell us why you would like to adopt a dog in your own words. *

Please tell us in your own words why are you interested in this specific dog. *

Do you currently have any other applications to adopt with another rescue? If so, please name the organization and the status of your application. *

Have you fostered or adopted from another rescue/shelter in the past? If so, please name the organization *

If your first choice dog is not available to adopt, are you open to other dogs that we have? If so, please provide the name(s) of the other dog(s) that you are interested in and briefly explain why this dog would be a good alternative to your original choice. *

Are you currently: *

Working

Retired

Attending school

Other

Do you own or rent? *

Own

Rent

Live with parents

Other

If you rent, please indicate your landlord's name and contact phone or email address:

What type of dwelling do you live in? *

House

Townhouse

Condo townhouse

Condo high-rise

Semi-detached home

Apartment

Shared accommodations (roommate situation)

Other

How many people live in your household? *

Please tell us about the people in your household - yourself and your family. Include your age, occupation/source of income and the same for any other adults in the home. List children and their ages: *

Are there any children who frequently visit? Please provide their ages.

Have you talked to all of the people in your household about adding a dog to the household, and do they agree? *

Do any members of your household have dog allergies? *

Yes

No

Not sure, I haven't asked

Which member of your family will hold the primary responsibility for caring for the dog? *

Do you have a secure, fenced yard? *

Yes

No

How big is your backyard? (Dimensions, if possible) *

Describe the atmosphere at your home: *

Always busy

Some activity

Very quiet

Please provide us with information on your CURRENT pets. Include their name(s), breed, gender, whether they are neutered/spayed, declawed, indoor or outdoor, etc. *

Have your current pets seen a vet in the past year, and are they up to date on their vaccines? *

Do you treat your current pets with flea/tick prevention on a monthly basis? *

Yes

No

Have no current pets

Do you treat your current pet(s) with heartworm prevention on a monthly basis? *

Yes

No

Have no current pets

Please explain how you would introduce the new dog to your current pet(s) *

Please provide us with information on your PREVIOUS pets. Include your pet(s) name, breed, gender, whether they were neutered or spayed, declawed, indoor or outdoor, and why you no longer have the pet. *

How often are you prepared to take your new dog to the veterinarian? *

Once a year

As required

Never

Do you plan on treating your new dog with flea/tick prevention on a monthly basis? *

Yes

No

Undecided

Many of the dogs we rescue come from parts of the world where heartworm is very common. Do you plan on treating your new dog with heartworm prevention on a monthly basis, for at least the first year of getting the dog as recommended by a veterinarian? *

Yes

No

Undecided

How long will your dog be left alone each day? *

0-3hrs

3-6hrs

6-8hrs

8-10hrs

10+ hours

Please share your opinions on and experience with crate training. *

Will you keep your new dog on leash when not in a fully fenced area? *

Yes

No

Undecided

Where will you keep your dog when you are not at home, or at night? *

Where will you keep your dog when you are at home? *

If we provide advice about certain training/safety equipment, are you open to our recommendations? *

Yes

No

Undecided

Please share your opinions on and experience with retractable leashes. *

How will you exercise the dog, and how often? *

What type of issues would you be willing to work on with a dog? For example, aggression/reactivity to animals, aggression/reactivity to people, biting, nipping, growling, resource guarding, counter surfing, high prey drive, house training, chewing, barking, crate training, separation anxiety, etc. *

What type of dog issues would be unacceptable to you and cause you to return a pet? *

How will you discipline or correct your dog? *

Many of our dogs are adults that have never received any obedience training or experienced structure and routine prior to being rescued. Behavioural issues are common. Would you be willing to seek professional help if a behavioural problem were to arise? If so, which professional resource would you reply upon? *

Rescue dogs have often been through a lot of stress & instability. We emphasize the importance of routine and training in a positive manner without the unnecessary use of harsh leash corrections, rolling, pinning, or hitting. Do you accept this? *

Yes

No

Undecided

What will you do with your dog when you go on holidays? *

If for any reason you were no longer able to care for the dog (e.g., debilitating illness or a move to a retirement home), who would care for it? Please provide their name, age, relationship to you, phone number and confirm that you have already discussed this with them. *

How much money do you anticipate spending on your new dog on a yearly basis in order to feed, purchase supplies, and provide medical care for your dog? *

No matter how much rescue dogs are evaluated by their temporary care families, they may come with issues we do not know about, and the transition may take weeks or even months. Are you willing to give a dog at least two months to adjust to you, your family and their new environment before you would even consider not keeping them? *

Yes

No

Have you ever surrendered your own animal to an animal shelter or rescue, returned an adopted pet, or given a pet away? *

References/Veterinarian

Please provide four (4) NON-FAMILY references you have known for at least 2 years who know you as a pet owner or who can vouch for your overall responsibility. Because we are often unable to get a hold of references, causing a delay in processing applications, we require 4 individual references. We must speak to at least two (2) of your references before considering approving your adoption request.

Reference #1

Reference Name *

Contact Number *

Relationship *

Reference #2

Reference Name *

Contact Number *

Relationship *

Reference #3

Reference Name *

Contact Number *

Relationship *

Reference #4

Reference Name *

Contact Number *

Relationship *

Veterinarian

Current Veterinarian’s Name *

Current Veterinarian’s Address *

Current Veterinarian’s Phone *

IMPORTANT: Please advise your veterinarian and references that we will be contacting them.

PLEASE COMPLETE ALL FIELDS ABOVE TO ENSURE PROPER PROCESSING OF YOUR APPLICATION.

By submitting this application, the applicant and co-applicant(s) certify that the information given is true, and you understand that Pets Alive Niagara reserves the right to deny your application for any reason at any time. You further authorize the investigation of all statements in this application.

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