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General dog questions

How did you find out about Keeshond Lovers United? _________

Why do you want to adopt a dog? ________________________

Are you considering any other breed? _____________________

How long have you been looking for a dog? _________________

Are you aware of the financial obligations involved in owning a dog? ______________________________________________

List the yearly expenses you think this dog will require: _________

Do you know how to care for a dog’s coat and trim its nails? ____

Are you aware that the dog will have a heavy coat, sheds seasonally, is relatively active for its size, may bark to protect “his territory” and may dig holes? ____________________________
 

Your dog history and experience

As an adult, have you ever owned a dog? __________________
If so, when? _________________________________________
What happened to it? __________________________________
Have you ever:
    Had a pet that was stolen from you? _____________________
    Had a pet that disappeared? __________________________
    Had a pet that was poisoned? _________________________
    Had a pet that was killed by a vehicle?    __________________
    Had a pet that died of a disease? _______________________
    Had a pet that died from an accident? ___________________
If you answered yes to any of the above questions, please explain in detail: _______________________________________________
____________________________________________________

Have you ever housetrained a dog?  ________________________
If so, what method did you use? ____________________________
Have you ever obedience trained a dog? _____________________
Are you planning on obedience training this dog? _______________
Why or why not? ________________________________________
Have you ever crate trained a dog? _________________________
Are you willing to use a crate, if necessary? ___________________
Have you ever gotten rid of a pet? __________________________
If so, why? ____________________________________________
What circumstances, in your mind, justify getting rid of a pet? ______
_____________________________________________________

Are you planning to move in the near future? ___________________
If you had to move, would you have to give up your pet(s)? ________
Why or why not? ________________________________________

Your future dog plans

Do you intend to keep the dog indoors, outdoors, or both? ________
Do you have a dog house? ________________________________
Where will this dog sleep? ________________________________
Do you have a yard? ____________________________________
If so, is it fenced? _______________________________________
If it is fenced, what kind of fencing? __________________________
Is your yard completely enclosed by fencing? __________________
If you do not have a fence or your yard is not completely enclosed by the fence, how do you plan to exercise this dog? _______________
How will the dog be pottied? ______________________________
Will your dog be allowed in all parts of the house? ______________
If not, which parts will be off limits? __________________________
Will your dog be allowed on furniture? ________________________
When you are away (vacations, business travel, etc.), what will happen to your dog? ____________________________________
Will it travel with you? ____________________________________
Board in a kennel? ______________________________________
Dog sitter come to your house? ____________________________
Stay at a friend/relative’s house? ___________________________
If yes, which friend/relative? _______________________________
Who will be responsible for feeding this dog? __________________
For exercise? _________________________________________
For vet care? __________________________________________
For training? __________________________________________
What type of dog activities will you and this dog participate in?  (examples: obedience, agility, etc.) _________________________
Are you willing to take your dog for regular veterinarian visits and keep current on appropriate vaccinations? ____________________
Are you willing to abide by animal leash laws, licensing, and pooper-scooper laws in your community? _____________________
Are you familiar with the animal regulations in your area? _________
What are they? _________________________________________
Are you willing to make a commitment to provide for this dog for its entire life span, which could last up to 20 years? ________________

Other pet (former and current) information

List all pets you currently have by type, age, and sex.  Indicate if spayed or neutered. _____________________________________
_____________________________________________________
Are all dogs current on shots? _____________________________
Are all dogs on heartworm preventative and/or checked annually? ______________________
Are all cats current on shots? ______________________________
List all pets you have had in the past.  Indicate what happened to each one. _____________________________________________
_____________________________________________________
_____________________________________________________
Has your ownership of a pet ever caused you to be in a court situation? _____________________________________________
If yes, please explain. ____________________________________
_____________________________________________________


Household information

Who lives in your household?  (Include all occupants, including yourself, by name and age and relationship) 
_____________________________________________________
_____________________________________________________
_____________________________________________________
Is there anyone in the household who does not want to adopt a dog?
_____________________________________________________
What are their names? ___________________________________
What are their reasons? __________________________________
Do any household members have allergies? __________________
If yes, indicate to what. ___________________________________
Do all family adults work? _________________________________
Is someone home during the day? __________________________
If nobody is home during the day, what provisions will be made for your dog? ____________________________________________
How many hours a day will the dog be alone? __________________

References

Veterinarians used in the past five years:

Name: _______________________________________________
Address: _____________________________________________
Phone: _______________________________________________
We will ask this vet for a reference.

If you haven’t had a vet in the past 5 years, please list the one you are planning to use for this dog: ______________________________
___________________________________________________

Provide three personal references who can attest to your interest, interaction, and feelings about animals in general and dogs in particular:

Name: _______________________________________________
Relationship: __________________________________________
Known how long: _______________________________________
Address: _____________________________________________
Daytime phone: ________________________________________
Nighttime phone: _______________________________________
Best time to call: _______________________________________

Name: _______________________________________________
Relationship: __________________________________________
Known how long: _______________________________________
Address: _____________________________________________
Daytime phone: ________________________________________
Nighttime phone: _______________________________________
Best time to call: _______________________________________

Name: _______________________________________________
Relationship: __________________________________________
Known how long: _______________________________________
Address: _____________________________________________
Daytime phone: ________________________________________
Nighttime phone: _______________________________________
Best time to call: _______________________________________


Return contract to Judy Hintzman:

email:  jahintzie@sunflower.com

mail:  3917 Trail Road, Lawrence, KS  66049

phone:  785-550-5429