Adoption Questionnaire

What pet are you interested in?

Your first name

Your surname

Your address

Town/City

Postcode

Contact number

Email address

Have you had pets before? Have you had pets before? Yes No As a child

Please provide as much information as possible including, type, age, if they are neutered and vaccinated.

Are your current pets Are your current pets Neutered Vaccinated Insured

Where are your pets kept during the day/night?

Which vets do you use?

How many adults live at home? How many adults live at home?12345

Do you have children living at home? Do you have children living at home? Yes No

Do you have any children visiting? Do you have any children visiting? Yes No

Do all adults in your home consent to having a new pet? Do all adults in your home consent to having a new pet? Yes No

Are you or any family member allergic to pets? Are you or any family member allergic to pets? Yes No

Is someone home most of the day? Is someone home most of the day? Yes No

If you work, will your hours be changing in the near future? If you work, will your hours be changing in the near future? Yes No

Are you planning on getting a new job soon or in the near future? Are you planning on getting a new job soon or in the near future? Yes No

Are you planning a holiday in the near future? Are you planning a holiday in the near future? Yes No

Are you planning a family in the near future? Are you planning a family in the near future? Yes No

Is your home Is your home Owned Rented*

What type of home do you have? What type of home do you have? House Flat Other

Please specify your type of home

How long have you lived there?

Do you have a yard or garden? Do you have a yard or garden? Yes No

Is your garden for your use only or shared? Is your garden for your use only or shared? Sole use Shared

Height of garden fence?

Have you considered the cost outlined above of owning a pet? Have you considered the cost outlined above of owning a pet? Yes No