<p> AINMHITHE ANIMAL RESCUE </p><p>PRE ADOPTION QUESTIONNAIRE</p><p>Date ______</p><p>Name of the dog you are interested ______</p><p>Your Name ______</p><p>Address______</p><p>______</p><p>Email______Phone______</p><p>How many people live in your home? ______</p><p>Children? ______Ages: ______</p><p>Do you have a house, townhouse, apartment, other? </p><p>______a) Do you own, or rent? If you rent, do you have your landlord’s written permission? </p><p>______b) Do you have a fenced yard, dog run, or neither? </p><p>______1) How long have you been thinking about acquiring a dog? </p><p>______2) Has every one in the household discussed adopting a new pet?</p><p>______3) Why are you looking for a dog? (Security, companion, company for other pet, etc…) </p><p>______4) Is any one in your home allergic to animals? </p><p>______</p><p>5) Will someone be home during the day? </p><p>______6) How long will the dog be left alone during the day? </p><p>______7) Where will the dog sleep? </p><p>______8) Where will the dog spend the days? </p><p>______9) When was the last time you had a dog? Or do you now? What Kind of dog was it? </p><p>______10) Was/is s/he spayed or neutered? </p><p>______11) What happened to the dog? </p><p>______</p><p>12) Please describe all other pets in the house: </p><p>______</p><p>13) This dog is desired for an: (Please circle) Individual – Couple – Family</p><p>Who will be ultimately responsible for the dog? </p><p>______14) How and how often, do you plan to exercise your dog? (e.g. walks on lead around neighbourhood, off lead walks, at beach, hills etc.) </p><p>14) Do you plan to obedience train the dog, if so, how? </p><p>______15) Please submit the name and address of your vet.</p><p>______16) Do you intend taking out pet insurance for the adopted animal?</p><p>______</p><p>I understand that AINMHITHE is an all-volunteer registered charity(nonprofit) I understand an adoption fee/donation of €150.00 is necessary to help offset costs incurred to rescue and care for each dog; (includes spay/neuter, vaccinations, food, etc.) As most animals cost us more than that to care for, you are also welcome to make a larger donation, if you wish, and are able to.</p><p>Now to the fun part of the pre-adoption form  Please Describe your “Dream Dog”! </p><p> Energy level? (Please circle) Low – Low/Med. – Med. – Med./High – High </p><p> Expectations of behaviour? What would its personality be? (Please circle) </p><p>Silly – protective – passive – calm – playful – cute – couch potato – smart – live mostly outside – young – goofy – pretty – well behaved – cuddly - eager to please – older – do tricks – devoted – independent - funny looking – housebroken – buddy – guard dog – not a barker...</p><p> Anything else about what you would want/ expect in your dog:</p><p>______</p><p>Thank you so much for taking the time to fill this out, it really helps us to find the right companion for you! </p><p>RETURN TO: FRIENDS OF AINMHITHE CHAIRTY SHOP, JOHN STREET, BALLINA. CO. MAYO</p>