Adoption Questionnaire

I want to place the dogs I rescue in homes that are compatible with their needs and the needs of their new dog “parent.” To this end, please complete this important questionnaire as completely and truthfully as you can. There are no wrong answers! IMPORTANT: If you don't get a confirmation shortly after submitting this form, please notify us immediately by email. Thanks!

Due to browser and network differences, this form could time-out if the user waits an extended period of time before completion. Although most users complete the form without a problem, please be aware of this in order to avoid the issue.

Name (First) *

Name (Last) *

Email *

Address 1 *

Address 2

City *

State *

Zip Code *

Home Phone *

Cell Phone

Work Phone

Housing Type

House
Apartment

Apartment Number

Landlord's Phone (if applicable)

Does your home have any pet restrictions? *

Yes
No

How many people live in your home? *

Please provide ages and relationship. *

What dog(s) are you interested in? *

Your Daily Schedule *

Gender preference?

Male
Female
No preference

Breed preference?

Yes
No

If yes, what breeds?

Size preference?

Small (under 30 lbs)
Medium (30-50 lbs)
Large (over 50 lbs)
No preference

What are the most important characteristics in a dog? *

What behaviors concern you the most? *

Do you have a fenced yard?

Yes
No

Many dogs react well to obedience training, and such training often solves other problems like chewing, housetraining, and marking.

Are you willing to take your new dog for obedience training if needed? *

Yes
No
Maybe

Please explain your answer. *

How would you discipline a dog that would not come when you called him? *

How would discipline a dog who is growling at a visitor or another dog. *

How would you discipline a dog that had a housetraining accident during the day while you are out? *

What is your pet history? *

Who is your vet? *

2 References (if no vet history)

Other information

*Please note: Mary's Dogs rescued pups MUST be indoor animals only, must be spayed or neutered, and must be returned to Mary's Dogs if an adoption does not work out for any reason.

IMPORTANT: If you don't get a confirmation shortly after submitting this form, please notify us immediately by email. Thanks