 |
Cedar Valley Boxer Rescue Adoption Home Evaluation |
No.__________ |
This questionnaire is prepared for
benefit of both the dog and the prospective owner. It will enable us to place
the right dog with the right prospective owner.
Name: ___________________________________
Address: _______________________________________
City: ________________________________
State: _______________________________ Zip: ___________
Phone (home, work, cell):
_________________________________ email: ____________________________
Occupation:
________________________________________
1) Why do you want a Boxer?
_______________________________________________________________
2) Have you ever owned a Boxer?
____________________________________________________________
What happened to him/her?
_______________________________________________________________
3) Do you have a fenced yard? _______________________________ Height,
Length: __________________
4) Will the Boxer be kept indoors or outdoors?
__________________________________________________
5) Do you have other pets? _____________ What kind & sex?
_____________________________________
6) Does everyone in your family want a Boxer?
_________________________________________________
7) What sex of dog do you prefer?
____________________________________________________________
8) Will you keep the Boxer on Heartworm Preventative?
__________________________________________
9) Do you have a veterinarian to care for the Boxer?
______________________________________________
10) Will you keep the dog's vaccinations up to date and take the dog in for annual exams? _______________
11) How did you find out about our
program? ____________________________________________________
12) Your comments and suggestions: ___________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Your
Signature: ______________________________ Date: ______________