Puppy Love Rescue

Adoption Questionnaire

Name:____________________________                  Date:_________________

Address:_________________________                  Name of pet you are
Major Street Near you: ________________________    interested in adopting:
City:_______________Zip:_________                  ______________________

Phone:Home:_____________Work______________Cell:_________________

Email:___________________________


House?_______ Condo?_______ Duplex?________ Apartment?__________
Own?_____Rent?_____

Back yard?_________ Height of fence_________
Is your fence secure? ______________________

Number of hours gone per day: ____________


Are you looking for an [ ] inside pet or an [ ] outside pet? [ ] both?


Family Members:  Total Family Members: ____________________

                 Number of adults living in the home:___________

                 Number of children:_______ Ages:_________________

                 Number of visiting children:_____ Ages :_________
				 How often do visiting children come _____________
				 
Dogs?_____ how many?_____ Sexes?___________Are all your dogs spayed or neutered?_____
Breeds?___________________________________________________Ages:_________
Cats?______ how many?______Sexes?__________Are all your cats spayed or neutered?______
Other pets?____________________________________________________________

Comments:  Why do you want to adopt a pet, your areas of interest, etc. 
_____________________________________________________________________________
_____________________________________________________________________________

What happened to your previous pets?___________________________________________________

Have you ever had a dogs’ ears cropped, tailed docked, 
debarked or cat declawed?________________

I am aware that adopting a pet is a lifetime commitment, usually lasting 10 to 15 years. 

I am aware this is only a questionnaire, not an adoption agreement.

Signature:______________________________

Puppy Love Rescue
P. O. Box 13543
Sacramento, CA  95815