Self information form

Which animal you want to adopt?

Full name

Street + Nr.

City, Country

Phone number

Email adress

Birthday

Nr.of people living in same household:

+ -

Children in same household:

Age of the children

Full name of your partner:

Employment

Are you working?

yes

no

If so: daily working hours including travel time:

Is your partner working?

yes

no

If so: daily working hours including travel time:

Your home

How do you live?

Approx.size in sqm:

When renting: is there a landlord's certificate for keeping a dog?

yes

no

Balcony:

yes

no

Garden:

yes

no

Approx.size in sqm::

+ -

If so, is the garden fenced ? Complete? How high?

Housing the animal

Do other animals live in the household?

yes

no

If yes, what animals, age, castrated?

If cats are present, can they initially be kept spatially separated?

Are there other small animals in the household?

Are existing dogs completely vaccinated?

yes

no

Did you have own dogs before?

yes

no

If yes, how many and which breeds?

Dog experience in years:

Are the dogs living in your household compatible with other dogs?

Have you already had dogs from animal welfare abroad?

yes

no

Are you familiar with Mediterranean diseases?

yes

no

What would be a reason for you to give up the new dog?

How many hours a day would the dog have to be alone?

If you've owned a dog before - did it die, ran away, or did you give it up? If submitted, for what reason?

Do you have enough patience, time and understanding for the new animal? (E.g. fearfulness, house-training, getting used to other animals in the household, staying alone)

Can you ensure sufficient contact with other dogs?

Where is the animal when you will go on vacation?

Who takes care of the animal in the event of illness or death?

Do you or one of your family members have an allergy?

Do all family members agree with the adoption?

yes

no

Are you aware....

...that dogs loose hair?

yes

no

...that furnishings or clothes can be destroyed?

yes

no

...that staying alone must be practiced?

yes

no

...that walking has to be practiced?

yes

no

Can you take a vacation when the dog arrives?

Which rooms is the dog not allowed in ?

Where the dog should stay?

Why do you want to get a dog?

Are you aware of the cost of having a dog? (Nominal fee, food, vet, insurance, dog tax, ...)

If the dog is too young, do you plan to have it neutered later?

Have you ever had a home-check for a dog?

yes

no

If so, can you please give us contact details as a reference?

Have you applied for other dogs at the same time?

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I confirm that I have provided the above information to the best of my knowledge and belief and that they are correct and complete.

Your message for us:

SELF INFORMATION FORM FOR FUTURE ADOPTERS*