Chipping Norton

                                                                        07956 822402


                             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
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
Occupation of self and partner
Hobbies and Interests
                                                 Chipping Norton

                                                    07956 822402

Full Dog History dog(s) owned &
current e.g.
Breed types Bred from or neutered
Rehomed or cause of death
Other relevant / previous dog
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
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,
Type of property e.g. semi or terrace
Owned / private rented / council /
housing ass.
If rented, written permission to keep a
Time at present address / any plans to
                                                    Chipping Norton

                                                       07956 822402

Location Rural/ urban; main road, cul
de sac, estate)
Garden size Access and type of gates
Fencing type & lowest height (Email
State of repair, fox holes, fishpond or
Garden security to prevent dog theft
Local dog walking areas you plan to
use e.g. street, town, park or
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

when out? Other arrangements whilst
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

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 and let us
    know if you manage to find your dog through another source. Good luck!

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