Adopt a Dog – Form Step 1 of 2 50% Thank you for your interest in adopting a dog from Second Chance. Adopting saves lives. This survey will be sent to an adoption counselor, who will help you find the dog most compatible with your lifestyle. General InformationName(s)*Address* Street Address Address Line 2 City State ZIP Code Home PhoneCell Phone*Email* Please note that our adoption counselors are all volunteer, and our first contact with you will likely be an email. Make sure you check your junk mail and filters so you don't miss our response! Household & LifestyleAre you aware of any restrictions (rules from a landlord, condo association, homeowner's insurance, etc.) that would prevent you from adopting a pet from Second Chance?* No restrictions There are age restrictions There are breed restrictions There are weight restrictions I can only have a limited number I don't know May we contact your landlord?* Yes No No, I own my home Landlord name and phone numberHow experienced do you feel caring for a dog?*No experience – but excited to learn!Some experience – have owned a dog beforeLots of experience – my friends and family consider me an expert!How experienced do you feel providing veterinary care for a dog?*No experience – I would like a recommendation on a veterinarian in my areaSome experience – I have a veterinarian I know I can callLots of experience – I love my vet!May we contact your vet to check on the health status of your other pets?*YesNoNo, I do not currently have a vetVet Clinic NameVeterinary Phone NumberTell us about the other members of your household. How do they feel about adding a dog to your household?*How would you describe the energy/activity level of your home?*Tell us about any other pets currently living in your home (age, activity level, personality, etc.).*Proof of Rabies Vaccination on Current PetsTo speed up your adoption process, please attach proof of your current dog(s) rabies vaccine(s). A copy of the rabies certificate or picture of the rabies tag is acceptable. Drop files here or Accepted file types: jpeg, pdf, gif, png. Is there anything specific you are looking for in a dog (age, sex, activity level, personality)?*How do you imagine spending an average day with your new companion? For example, where will your dog stay while you are out of the house? Do you hope to have a dog you can exercise with daily?*What situations might leave you feeling like your new dog just isn’t a good fit for your home and could lead you to return him or her to us?*Some of our dogs can be slow to adjust to a new environment, while some adjust instantly. Is having a dog that adjusts quickly important to you?*YesNoWhat aspects of taking home a new dog would you like to discuss further with our adoption counselors?* House Training Crate Training Introducing your new dog to current pets Finding a veterinarian Dog food/nutrition Helping children interact safely with dogs Other What else would you like to be able to discuss with our adoption counselors?What are you looking for in a dog?Weight (give a range)Age (give a range)Activity Level (low, medium, high) Please include any additional information that you think may help our adoption counselors find the perfect dog for you.Of our currently available animals, which dog do you believe best matches your home and lifestyle?