Family Profile Form

Family Profile Form
Name:
Full Physical Address:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Names and relations of other adults in household:
Names and ages of children in household:
Other pets names, types, ages and sex:
Are other dogs in the household spayed or nuetered?
Name and phone number of current veterinarian	Name Phone
Two non-family references are requested ... please give name, phone # AND email address for each:	1. 2.
Do you own or rent?
If you rent, please provide landlord's name and phone # for contact:	Name Phone
What type dwelling do you live in? (house, apartment, condo, townhouse, etc...)
Are your plans to keep the dog inside, outside or both?
Please describe your yard... size of yard and type of fence (height): (please note: a fenced yard IS a requirement)
If the dog would be outside during the day, please describe shelter it would have:
'Work' routines of adults in household (how much time would the dog be spending at home alone each day)?
What is your dog ownership history?
If this will be the only dog in your household, do you have friends, family or neighbors with dogs for this one to interact with to maintain it's canine social skills? Explain:
Briefly explain why you would like to adopt a dog:
Do you have a breed, age or sex preference?
Which dog are you particularly interested in?
Feel free to add any other pertinent or beneficial information that will help me determine if this dog is a good match for your family: