Adoption Questionnaire – Barnsley Animal Rescue Charity

Name*

First Last

Which dog are you making an enquiry about?*

Address*

Number and Street Locality Town/City County Post Code

Phone*

Email*

Are you a permanent resident in the UK?*

Yes
No

Age Group*

18 - 20
20 - 40
40 - 60
60+

What size, type, age of dog are you looking for?*

Male, Female or no Preference*

Male
Female
no Preference

Who lives with you? Adults, Children*

Any visiting children and how often?*

Does everyone at home want a dog?*

Is anyone allergic to cats or dogs?*

Do you live in a House/Flat/Other?*

Is your home Rented/Owned?*

If rented, do you have your landlords permission?*

Do you have a fully enclosed garden?*

Minimum height of fence?*

Less than 4ft
4 - 5ft
5 - 6ft
Higher

Are you planning any of the following?*

A Baby
Moving House
Holiday Soon
Change of working hours
None of these

Have you owned a dog before?*

What happened to your dog?*

How long will the dog be left at home for during the day?*

If you work, will the dog be able to go with you?*

What arrangements are in place when you have to leave the dog?*

Do you own any other pets?*

Yes
No

If yes, mention what they are?

Are all other dogs in the home neutered?

Yes
No

Have you or anyone in your immediate family been convicted of abusing of being cruel to any animal?*

How did you hear about us?

You understand that the dog will be rehomed as a house pet and is not to be kept kennelled or chained up outside. The dog will be rehomed to you as a companion, not as a guard dog or for breeding purposes

BARC reserves the right to reclaim the dog if it feels the dog is not being housed, fed or cared for to its satisfaction

Full liability for any veterinary fees incurred at any future date remain your liability.

If you live in rented accommodation BARC may contact your landlord

You understand that although we tell you everything we know about the dog, we do not always have a complete history and therefore cannot guarantee behaviour etc

BARC is here to advise on any aspect of caring for the dog. It may take 6 months or more for the dog to settle in

Signature*

Dog Home-finding Questionnaire

Registered address: