Fillable Dog Adoption Survey (Humane Society of Kitchener Waterloo & Stratford Perth)

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Dog Adoption Survey (Humane Society of Kitchener Waterloo & Stratford Perth)

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The Dog Adoption Survey (Humane Society of Kitchener Waterloo & Stratford Perth) form is 2 pages long and contains:

  • 0 signatures
  • 74 check-boxes
  • 21 other fields

Country of origin: CANADA
File type: PDF

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Name: _________ Partner’s Name____________________________________
Address: __________________________ Apt # ______________________
City: ___________________ Postal: _______
Email: ___________________________________________
Home phone: __________ Cell phone: ________________
Work Phone: _______________________________ Extension: ______________________________
Thank you for visiting the Humane Society of Kitchener Waterloo & Stratford Perth
and choosing to save a life! Please help us find a great canine match for you by
filing out this adoption survey. We are excited to help you pick your new family
member!
Dog Adoption Survey
Adopter Information:
Animal Information: (Animal ID Number can be found on the animals profile page on our website)
Animal Name:______________________________ Breed:________________________________
Animal ID #_________________________________________
1. What best describes your dog experience?
□ I’ve never had a dog □ I had a dog 1+ years ago □ I had a dog within the last year □ I currently have a dog
2. I would best describe my household as:
□ A place with constant activity and noise □ Sometimes noisy/quiet □ Quiet and calm most of the time
3.My dog must get along with: (Check all that apply)
4. When I am not at home, my dog will be:
□ In the garage □ Outside or in the yard □In a crate in the house □ Confined to one room □ Loose in house
5. When I am at home, my dog will be:
□ In the garage □ Outside or in the yard □In a crate in the house □ Confined to one room □ Loose in house
More on reverse:
The Humane Society of Kitchener Waterloo & Straord Perth (HSKWSP)
For more informaon on our adopon process during Covid-19, please visit us at kwsphumane.ca
□ Cats □ Dogs (List breed below) □Kids (List ages below) □ Other (List below)
___________________________ _____________________ _________________
6. I want a dog who: (Check one per box)
Dog Adoption Survey (Con’t)
Interacts with houseguests:
□ All the time
□ Sometimes
□ Not Important
Can be alone:
□ More than 9 hours per day
□ 4-8 hours per day
□ Less than 4 hours per day
Likes to be by my side:
□ All the time
□ Some of the time
□ Not Important
Enjoys being held:
□ All the time
□ Some of the time
□ Not important
Enjoys being with children:
□ All the time
□ Some of the time
□ Not important
Is playful and active:
□ All of the time
□ Some of the time
□ Not important
Is vocal or talkative:
□ All of the time
□ Some of the time
□ Not important
Can adjust to new situations
□ All of the time
□ Some of the time
□ Not important
□ Has no training
□ Has had some basic training
□ Had had a lot of training
□ Has special needs (behaviour/
medical needs)
7. The personality I am looking for, in a dog is: ___________________________________________
8. My outings include: (Check one per box)
Travel more than 2
hours away:
□ Once a year
□ More than once a year
□ Not very often
□ Never
Hiking:
□ Once a year
□ More than once a year
□ Not very often
□ Never
Camping:
□ Once a year
□ More than once a year
□ Not very often
□ Never
My dog will be alone
for _______ hours
per day
8. I have training experience with: (Check all that apply)
Puppies:
□ Socialization classes
□ Obedience
□ Housetraining
□ None
Adults:
□ Socialization classes
□ Obedience
□ Housetraining
□ None
Other:
□ Resource guarding
□ Loose leash walking
□ Undesirable behaviours with other
animals
I acknowledge that:
□ I am financially able to provide veterinary care, proper nutrition and any training this dog may need
□ I have the time to provide training and enrichment for this dog
Applicant’s Signature Date
HSKWSP Staff/Vol Signature Date
Please email completed Adopon Survey and Adopon Agreement to the following email address: For animals available at our Straord
locaon: Animal-care@kwsphumane.ca. For animals available at our Kitchener locaon: Animalcare@kwsphumane.ca
Please note that we are unable to accept blank applicaons at this me
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Dog Adoption Survey (Humane Society of Kitchener Waterloo & Stratford Perth)

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Completed 30 August 2020

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