Name *

First Name

Last Name

Spouse's Name

(If applicable)

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Spouse's Phone Number

(If applicable)

(###)

###

####

Birthdate *

MM

DD

YYYY

Are you interested in a bonded pair? *

Yes

No

Are you interested in fostering to adopt? *

Yes

Maybe

No

Are you comfortable paying for food? *

Yes

Maybe

No

Any visiting children? *

Yes

No

Any dog allergies in the household? *

Yes

No

Maybe

Are you planning any of the following in the next month? *

Moving

Change in schedule

Vacation

None

What is the most accurate description of your neighbourhood? *

City

Busy Suburb

Quiet Suburb

Rural

What kind of home do you live in? *

House

Basement Apartment

Apartment

Condo

Acreage

What type of yard do you have? *

Fully fenced

Semi fenced

No fence

Electric fence

Stake in the ground with long line

Shared yard

No yard

Do you *

Own

Rent

If renting, do you have your landlord's permission to have pets? *

Yes

No

Not applicable

Where will the dog stay during the day when home alone? *

Crate

Loose in the house

Garage

Backyard

In the house and outside through the open door/dog door

Tied in the backyard

Section of the house

Own room

Outdoor dog run

Where will the dog stay during the night? *

Crate

Loose in the house

Garage

Backyard

In the house and outside through open door/dog door

Tied in the backyard

Section of the house

Own room

Outdoor dog run

While at work are you planning on any of the following *

Hire a dog walker

Bring the dog to dog daycare

Have a neighbour or family member take the dog out

Walk before I leave for work and as soon as I come home

I am retired

i work from home

What is the main purpose of the dog? *

For myself

For my spouse

For my kids

For my current dog

Guard dog/protection

Competition dog

Working dog

Farm dog

Hunting

Have you had dogs before? *

Yes

No

In my childhood home

Have you ever surrendered or given away a pet? *

Yes

No

What would you enjoy doing with the dog? *

Jogging

Off-leash parks

On-leash walking

Off-leash walking

Scent detection

Cycling

Competition training

Hunting

Are there other dogs in your household? *

1

2

3

4+

None

Are there other pets in your household? *

Cat

Bird

Rodent

Reptile

Fish

None

If you have/had a cat, where do/did they spend time? *

Inside only

Both inside and outside

Outside

Not applicable, I have not had a cat

Do you have a gender preference? *

Male

Female

No preference

Do you have a coat/fur preference? *

Short

Medium

Long

Non-Shedding

No preference

Do you have an age preference? *

Puppy

Adult

Senior

No preference

Do you have a size preference? *

Small

Medium

Large

No preference

What problems are you willing to work with? *

Separation Anxiety

Reactivity to dogs

Dog aggression

Excitability

Barking

Mild aggression

Vocalization

Obedience

House training

Fearfulness

I am not willing to work on any problems

Do you need a dog who is already trained? *

Yes

No

Are you open to fostering a dog with special needs or medical needs? *

Yes

No

Maybe

Have you done obedience training with a dog before? *

Yes

No

Do you have a lot of experience and think you can handle a difficult dog? *

Yes

No

Under which circumstances would you return a foster dog to the rescue? *

Moving

New baby

If the dog bit me

If the dog bit a stranger/visitor

If the dog bit a dog

Medical reasons with the dog

Not enough time

Behaviour problem

Destructive of the house

Accidents in the house

I would not return a dog

Have you ever been convicted of neglect or cruelty to animals? *

Yes

No

Are you willing to have a Dog Tales representative do a home visit by appointment? *

Yes

No

Date Signed *

MM

DD

YYYY