Puppy or a young dog

Name*

Prefix First Last

Address*

Street Address Address Line 2 County / State / Region ZIP / Postal Code

Phone*

Email*

DOB*

Profession*

How many adults live in the home?*

How many children live in the home?*

What are their ages?

Are there any children who visit regularly? If so, how old are they and how often do they visit?*

How busy is your house on average?*

Does anyone in the home suffer with allergies or asthma that may be triggered by the dog?*

Yes
No

If yes, please specify allergies

How many hours will the dog be left alone on weekdays? And how long on weekends?*

Who will walk the dog?*

How much time can you dedicate to exercising the dog?*

Have you considered dog walkers or sitters?*

Yes
No

What type of property do you live in?*

House
Bungalow
Flat
Other

If flat, please state floor level.

If other, please specify

Is your property owned or rented?*

Owned
Rented

If you rent have you got written permission from your landlord to own a dog?

Yes
No
Other

If other, please detail.

Do you have your own garden?*

Yes
No
Communal

If you have a garden, what size is it?

Small
Medium
Large

Where will the dog go to the toilet?*

Where will the dog sleep?*

Will the dog be allowed in your home?*

Yes
No

Will the dog be allowed on your furniture?*

Yes
No

Do you currently have other pets?*

Yes
No

If yes, please tell us more about them. Type of animal, age, sex, length of time owned, where they are housed and if they are neutered and vaccinated.

Please give the name and address of your Veterinary Surgeon if you have one.

Have you previously owned a dog or any other pets?*

Yes
No

If yes, please specify.

Have you previously rescued a dog?*

Yes
No

Do you have any experience of training dogs?*

Yes
No

If you selected yes, please specify

Have you managed any behavioural issues in the past?*

Yes
No

If you selected yes, please specify

What size dog are you looking for?*

Small
Medium
Large

Are you planning any of the following?*

A baby
Moving house
A holiday soon
Change in work hours
Home improvements
None of the above

I would like my new dog to:

Select All
like children
be good with cats
be good when left alone
like travelling in the car
be good with livestock
like other dogs
be housetrained
other

If you selected other, please specify

Why do you want a dog?

Is there any other information you would like to add to support your application?

Confirmation*

I confirm that I am over 18 years of age and all of the information I have provided is correct to the best of my knowledge.

Basket

Puppy/young dog