Kent County Animal Shelter - Dog Adoption Survey Page 2
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220. Do you plan on crate training your
26. What type of food will you feed your
32. Excitability
o
pet?
dog?
Could live with problem
o
o
o
Yes
Dry
Would do whatever it takes to
o
o
No
Canned
correct the behavior
o
o
o
Unsure, need more information
Table Scraps
Problem would prompt me to
o
Prescription if needed
part with the pet
21. Who will be responsible for
veterinary care?
27. How much will you budget to spend
33. Excessive Vocalization
annually on your dog’s medical
o
o
Family members take turns
Could live with problem
o
o
Mom/Dad
care?
Would do whatever it takes to
o
o
Individual
Less than $200
correct the behavior
o
o
$200-$400
Problem would prompt me to
22. Would you prefer to have your pet
o
$400-$600
part with the pet
trained…
o
More than $600
o
Without assistance
34. Jumps on people.
o
Whatever is necessary
o
o
With the help of a private trainer
Could live with problem
o
o
Group training class
28. Which veterinary hospital or clinic
Would do whatever it takes to
o
Leave pet at a training facility
do you use?
correct the behavior
o
o
Unsure, need more information
Problem would prompt me to
part with the pet
23. What other animals (not your own)
29. Primary purpose for obtaining your
will your pet interact with?
pet:
35. Chewing/Digs/Destructive
o
o
o
Dogs
Companion
Could live with problem
o
o
o
Cats
Family pet
Would do whatever it takes to
Child’s pet
o
o
Other
correct the behavior
o
o
o
Often
Hunting
Problem would prompt me to
o
o
Rarely
Protection
part with the pet
o
o
Never
Farm/outside pet
36. How important is it to you that your
o
Other
24. If you have other pets, how will you
pet want to sit in your lap, follow
handle introducing a new dog?
30. Has someone in your household
you around, etc?
o
o
Keep separate at first
owned a puppy less than 6 months of
Very important
o
o
Slowly over several days
age?
Important
o
o
o
Put new dog on leash
Yes
Not Important
o
o
o
Just put them together
No
I would rather have an
o
How long ago?
independent dog
25. How much will you budget monthly
for your dog’s food?
31. House training problems
37. How do you plan to groom your pet?
o
o
o
$20-$50
Could live with the problem
At home
o
o
o
$50-$100
Would do whatever it takes to
Professionally if necessary
o
o
More than $100
correct the problem
As infrequently as possible
o
Problem would prompt me to
part with the pet
Certification, Authorizations, Releases and Understandings
1.
I certify that all statements on this adoption application are made truthfully and without evasion, and further understand and agree
that such statements may be investigated and if found to be false will be sufficient reason for not being allowed to adopt from the
Kent County Animal Shelter (KCAS).
2.
I authorize the KCAS to contact my veterinarians(s) and anyone else KCAS deems necessary to confirm how I have cared for my
companion animals and/or how I am likely to care for any companion animal(s) I adopt from KCAS.
3.
I authorize my veterinarian(s) to release to KCAS all veterinary records of the animals I own or have owned.
4.
I understand that, with proper care, dogs can live 15 years or more and I am prepared to commit myself to the long-term care and
protection of any animal I adopt from the KCAS.
5.
I understand that animal(s) I adopt from KCAS may require veterinary medical or health treatment beyond that provided by
KCAS prior to my taking the animal(s) home. Such additional veterinary medical treatment could be costly. I acknowledge that
KCAS is not responsible for providing any additional veterinary treatment or the incurring cost of any additional veterinary
treatment provided by veterinarians I select to provide such treatment.
6.
I will not sell or give away animal(s) I adopt from KCAS. As long as I live in the service are of KCAS, I agree to return the
animal(s) to KCAS in the event I cannot keep or choose not to keep the anima(s). If I move from the are, I agree to take the
animal(s) to the local humane society or comparable local animal welfare organization.
Date:___________________________________ Applicant Signature:____________________________________________
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