Dog Adoption Application Page 2
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212.
What energy level are you looking for in a dog? (circle) High
Medium
Low
Not sure
13.
How do you exercise your current dog, or how do you plan on exercising your new dog? (check all that apply)
____ Leashed walks
____ Off-leash dog park
____ Playtime in unfenced yard
____ Hiking
____ Leashed jogs/runs
____ Playtime in fenced yard
____ Outdoor dog pen
____ Treadmill
____ Indoor play
____ Playing fetch
____ Tie-out in yard
____ Agility Training
Other:______________________________________________________________________________________
14.
How often do you/will you exercise your dog?_______________________________________________________
15.
Do you have a completely fenced yard? If yes, describe the type and height:__________________________________________
Does your home have a dog or cat door? No___ If yes, dog or cat?________
16.
Describe the living environment for your new dog:
____ House pet, living inside with family, except for exercise and elimination
____ Pet will live in basement, garage, porch or sunroom
____ Pet will live mostly outside, inside in bad weather
____ Pet will live outside with a dog house
____ Pet will live outside with access to barn or other building
____ Other or comments:__________________________________________________________________________________
17.
How many hours each day will your dog be home alone (without human companionship)?________________________________
18.
When home alone, your dog will be: (check all that apply)
____ Loose inside house
____ Outside in fenced area if nice weather
____ In a crate inside house until house trained
____ Outside in fenced yard
____ In a crate inside house
____ Outside free to roam in unfenced area
____ In a garage, sunroom, basement
____ Outside in dog pen
____ Inside or outside in fenced yard, using doggie door
____ Outside secured to a chain or cable
____ Will go to dog daycare
____ Other:________________________________________
19.
How important is it that the dog you adopt has already been house trained? (circle)
Very important
Somewhat
Not important, I will house train
Doesn’t matter, dog will live outside
20.
Describe the house training method you will use (or tell us if you need advice):_________________________________________
_______________________________________________________________________________________________________
21.
What type of obedience training do you plan to do? (circle all that apply)
In-home professional trainer
Obedience classes
I will train myself
None, I don’t care if my dog is trained
Other:______________________________________________
22.
What will you do with your dog if you move in the future?_____________________________________________
23.
How much do you expect to spend yearly on food, veterinary care, and other costs associated with caring for your dog?_________
What would you do if the vet bills went over this amount?__________________________________________
24.
Would you allow our representative to visit your home before the adoption is completed? Yes____ No____
25.
Are you prepared to make a commitment to care for your new dog for his/her entire lifetime, which could be 10 to 15 years or more?
Yes___ No___ Have you made provisions for your pet if something should happen to you? No___ Yes:____________________
26.
It may take your new dog two or more weeks to adjust to your home, especially if other pets are involved.
Are you prepared to allow this much time? Yes_____ No____
27.
Have you adopted a pet from us before?
No____ Yes:__________________________
Are you a volunteer with The Humane Society of Greater KC, or affiliated with our organization, or know someone affiliated? If yes,
please explain:__________________________________________________________________
Is there any additional info you’d like to provide?_______________________________________________________________________
_____________________________________________________________________________________________________________
By signing below, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in
my losing privilege of adopting a pet. I authorize investigation of all statements on this application. I understand that this application is
property of the Humane Society of Greater Kansas City.
Signature:____________________________________________________Date:_____________________________
Completed forms may be faxed to 913/596-2483 (fax #). Or emailed to:
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