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Chipping Norton 07956 822402 firstname.lastname@example.org COTSWOLD CANINE RESCUE QUESTIONAIRE HOMING QUESTIONNAIRE Please answer all questions fully as this information helps us to ascertain which dog(s) is suitable for your lifestyle. Please bear with us as we are all voluntary and can not always contact everyone. Please call us if you have not heard back within a couple of days and keep in touch. Please call Lucie on 07956822402 Dog type of you are looking for: Breed/size Age & sex – dog’s name (if applicable) If the dog is under age to be neutered are you willing to sign a contract to confirm you will have this done AND provide evidence (signed vet document) at a date stated by CCR? Other desired requirements: e.g. energy levels, Coat type, level of training Contact Details / About You Name of adopter(s) and Age Full Address incl. Postcode Landline and mobile numbers E-mail address How did you learn about our organisation Occupation of self and partner Hobbies and Interests Chipping Norton 07956 822402 email@example.com Full Dog History dog(s) owned & current e.g. Breed types Bred from or neutered Rehomed or cause of death Other relevant / previous dog experience When are you ready to adopt a dog? Holidays booked in the near future? Do you have transport to collect / return a dog? Household details: Other Adults – (Inc. relationship to adopter) Children /Ages (Inc. regular visitors) Allergies or other special needs? Resident dog(s) & neutering status (Inc. regular visitors) Cats & other pets in the house Livestock living outside e.g. chickens, horses Type of property e.g. semi or terrace Owned / private rented / council / housing ass. If rented, written permission to keep a dog Time at present address / any plans to move Chipping Norton 07956 822402 firstname.lastname@example.org Location Rural/ urban; main road, cul de sac, estate) Garden size Access and type of gates Fencing type & lowest height (Email Pictures?) State of repair, fox holes, fishpond or pool Garden security to prevent dog theft Local dog walking areas you plan to use e.g. street, town, park or countryside Where will the dog sleep at night? How do you feel about dogs on furniture / beds? Vet’s full details for reference letter or other rescue’s home visit certificate / adoption form We ask for a minimum contribution of £150, for each dog, to allow us continue helping homeless dogs. On average our dogs cost us £250 for foster and vet care, such as vaccinating, neutering, micro-chipping, flea and worm treatment. Is this a problem for you? Absence from home: Actual working hours incl. travel time of adults and the approx. times dog will be left during a day Where will dog be left during the day or Chipping Norton 07956 822402 email@example.com when out? Other arrangements whilst out? Care arrangements for dog whilst you are away? If adopting a puppy: We would like any of our puppies to attend a training class near to your home. Have you researched nearest? Additional relevant supporting information. Are you expecting changes to the above inform Thank you, although we endeavour to reply to all enquiries, we regret this is not always possible. A complete and detailed questionnaire does help us to match the right dog to your life style & circumstance. If for some reason the dog you are particularly interested in, is already being vetted for or doesn’t match your needs, we may contact you in the future to discuss a dog which seems appropriate for your needs and requirements. Keep in touch by emailing Lucie on firstname.lastname@example.org and let us know if you manage to find your dog through another source. Good luck!
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