We’re Happy You’re Ready to Adopt!

Name *

First Name

Last Name

Do you live in a *

house

townhouse

condo

apartment

other*

Phone

(###)

###

####

Preferred method of contact *

phone

email

text

Have you ever owned a Scottie before? *

pet

rescue

show

I have never owned a Scottie before

What kind of Scottie are you hoping to adopt? *

Male

Female

Either

Would you consider a Scottie mix? *

Yes

No

Would you consider adopting a Scottie that is heartworm positive? *

Yes

No

Would you consider adopting an older Scottie? *

Yes

No

Would you consider adopting 2 Scotties that are a bonded pair, and cannot be separated? *

Yes

No

Please indicate the age of the primary caregiver *

Under 21

21-25

26-35

36-45

46-55

56-65

66-75

Over 75

Are there any minor children living at home or will the dog come in contact with minor children? *

Yes, minor children in the home

No, no minor children in the home

No minor children in the home, but our dog will be in contact with minor children.

Is your yard securely fenced? *

Yes

No

Is there a pool or any other body of water on your property? *

Yes

No

Do you currently own ANY other pets? *

Yes

No

Have you ever surrendered any pets to a rescue or other shelter (humane society, animal control, etc.) *

Yes

No

Today's Date *

MM

DD

YYYY