Your Home Address
Family & Housing
List names & ages of all members of your household
What type of home do you live in single family, town home, apartment, farm, etc.?
Please describe your household:
Active Noisy Quiet Average
If you rent, please give the rules governing pets and the landlord’s name and number:
*By providing this information, you are allowing Doggie Bonez, Inc. to contact your landlord. Please inform them of this call so they will speak with us.
Is everyone in your home in agreement with the decision to adopt a dog?
Do you have time to provide adequate love and attention to a new dog or puppy?
Other Pets in the Home
What other pets do you currently have? (Specify type and number)
Have you ever surrendered a pet? If so, why?
Have you ever had a pet euthanized? If so, why?
How do you discipline your pets and why?
Do you have a regular veterinarian?
*By providing Doggie Bonez, Inc. with this information, you are allowing Doggie Bonez to call your vet. Please call your vet and inform them we will be calling to authorize the release of information to Doggie Bonez, Inc.
Do you agree to provide regular healthcare by a Licensed Veterinarian?
About the Dog you are Interested In
Which dog(s) are you interested in meeting?
Desired Sex of Dog
Spayed Female Neutered Male No Preference
Willing to Adopt
Outgoing/hyper Dog Dog that needs regular medication Shy dog Dog that needs training None of these
Where will the dog spend the day? How many hours alone? (Describe)
Where will the dog spend the night? (Describe)
When the dog goes out, how do you plan to supervise it? Fenced Yard?
Do you agree to contact Doggie Bonez, Inc. if you can no longer keep this dog?
Are you willing to let a representative od Doggie Bonez, Inc. visit your home by appointment?
All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.
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