Have you ever lived in a home that Yes No did not allow pets? How would you describe your home Moderate Easy-going environment? Are you able to provide a home for Yes No Maybe this pet’s entire life (Please consider finances and medical needs)? Do you foresee any major changes Marriage Children Health issues College in the next 15 years? Mark X to what applies or circle what applies. Graduation Moving Pets Other: Circle or X any reason that you wish Family Pet Child’s Pet Pet Gift Companion to adopt this pet. Service animal Breeding Showing Companion for Pet Circle or X any reason/ Moving New Baby Divorce Marriage circumstance that you would justify to give up a pet? Molting Loss of interest Time Person Consumption Allergies/Medical Problems Animal Medical Animal training Size/Activity Escaping enclosure/ Problems Problems of animal cage Not getting along Behavioral Other: with current pets Problems How do you plan on handling exercise, enrichment and excrements? How many hours will your pet Few (Less than 5) Average Many Other: spend home alone per day on (6-9 hours) (10-14) average? will your pet stay when on a In an enclosure in Loose in house outside In enclosure outside typical day? (check all that apply) Both indoor and In one room of In garage In barn outdoor access house Please detail the arrangements you have made for this pet to live in your home. Where will your pet stay when In an enclosure in in house Loose outside In enclosure outside home alone? (check all that apply) house Both indoor and In one room of In garage In barn outdoor access house Are you willing to adopt a pet with Yes No Maybe, it depends medical issues or special needs?
Have you ever lived in a home that did not allow pets? Yes No How would you describe your home environment? Moderate Easy-going Are you able to provide a home for this pet’s entire life (Please consider finances and medical needs)? Yes No Maybe Do you foresee any major changes in the next 15 years? Mark X to what applies or Marriage Children Health issues College circle what applies. Graduation Moving Pets Other: Circle or X any reason that you wish to adopt this pet. Family Pet Child’s Pet Pet Gift Companion Service animal Breeding Showing Companion for Pet Circle or X any reason/ circumstance that you would justify to give up a pet? Moving New Baby Divorce Marriage Molting Loss of interest Time Consumption Person Allergies/Medical Problems Animal Medical Problems Animal training Problems Size/Activity of animal Escaping enclosure/ cage Not getting along with current pets Behavioral Problems Other: How do you plan on handling exercise, enrichment and excrements? How many hours will your pet spend home alone per day on average? Few (Less than 5) Average (6-9 hours) Many (10-14) Other: will your pet stay when on a typical day? (check all that apply) In an enclosure in Loose in house outside In enclosure outside Both indoor and outdoor access In one room of house In garage In barn Please detail the arrangements you have made for this pet to live in your home. Where will your pet stay when home alone? (check all that apply) In an enclosure in house in house Loose outside In enclosure outside Both indoor and outdoor access In one room of house In garage In barn Are you willing to adopt a pet with medical issues or special needs? Yes No Maybe, it depends
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