Dog Intake Profile

"*" indicates required fields

Name*
Address*

The following questionnaire provides us with information about how your dog behaved in many different circumstances while he or she was living with you. Because your dog is likely to behave in similar ways in his new home, this information will help us find the most suitable home for your dog and to effectively counsel the new family. Your open and honest answers are very necessary and appreciated, so that we can do careful and successful adoptions. By signing below, I certify that the information I am about to provide is accurate and truthful to the best of my knowledge.
Is the pet spayed or neutered?*
Is your pet up to date on vaccines?*
Can you provide vet records?*
Your relationship to dog*

Where did you get this dog?*

Including yourself, how many people of the following ages live in or regularly visit your house?

What other animals does your dog live with?*
Does your dog usually uncontrollably chase or attempt to chase any of the following?*

The following questions are how your dog responds to…

Never encounterFriendlyAfraidShows Teeth/Growls/SnapsBitesNone of these
Men
Women
Children
Never encounterFriendlyAfraidShows Teeth/Growls/SnapsBitesNone of these
Men
Women
Children
Never encounterFriendlyAfraidShows Teeth/Growls/SnapsBitesNone of these
Dogs
Cats
Never encounterFriendlyAfraidShows Teeth/Growls/SnapsBitesNone of these
Dogs
Cats
Never encounterEnjoysAllowsAfraidShows Teeth/Growls/SnapsBitesNone of these
Bathe
Brush
Touch Feet
Approach when he has food
Approach when he has a rawhide
Approach while he is asleep
How does your dog usually react when a familiar person approaches or enters the yard or house?*
How does your dog usually react when an unfamiliar person approaches or enters the yard or house?*
Does your dog soil in your house? If no please skip to "are they paper-trained" question*
Do they always go in the same spots?
How often does your dog soil in your house?
How long have they been having accidents?
Are they paper-trained?*
Does your dog chase cats?*
When left alone, does your dog usually show any of the following behaviors? Please check all that apply.*
When your dog plays, does he/she typically… Please check all that apply.*
What toys does your dog like?*
What games does your dog like?*
What commands does your dog know?*

Behaviors, Diet & Veterinary

For the following questions please indicate if your dog has ever done any of these behaviors.
Please provide your veterinarian’s contact information.
Does your dog have to be muzzled at the veterinarian?*
Is your dog currently on any medication or special diet? If yes please list the type of food.*
What type of food does your dog eat?*
We know that your request is important and we will respond within 2 business days.
This field is for validation purposes and should be left unchanged.