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Second Chance Pet Adoptions (SCPAKC)

 

 

 

 

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Prescreening form


Having trouble with the prescreening? Copy and paste the below in an email to us secondchancepets@hotmail.com


PLEASE ANSWER THE FOLLOWING QUESTIONS TO ADOPT A PET.  PLEASE NOTE: SECOND CHANCE PET ADOPTIONS RESERVES THE RIGHT TO REFUSE ADOPTION TO ANYONE.


NAME: 
ADDRESS:  
CITY, STATE, ZIP: 
TELEPHONE NUMBER: 
E-MAIL ADDRESS:

WHICH DOG/PUPPY ARE YOU INTERESTED IN ADOPTING?

HOW LONG HAVE YOU BEEN LOOKING FOR A NEW DOG/PUPPY?

WHY DO YOU WANT THIS PET?

WHAT MADE YOU CHOOSE HIM OR HER?

HAVE YOU EVER ADOPTED A DOG FROM SECOND CHANCE OR ANY OTHER RESCUE ORGANIZATION?

HAVE YOU EVER BEEN DECLINED BY SECOND CHANCE OR ANY OTHER RESCUE ORGANIZATION? IF SO, PLEASE EXPLAIN.

PLEASE LIST ALL PETS YOU CURRENTLY OWN OR HAVE OWNED WITHIN THE LAST 10 YEARS. INCLUDE NAME, AGE, TYPE OF PET, HOW LONG YOU OWNED THE PET, AND WHERE THE PET IS NOW.

DO YOU OWN OR RENT? IF YOU RENT PLEASE LIST LANDLORD’S NAME AND PHONE NUMBER.

DO YOU CURRENTLY LIVE IN A HOUSE, DUPLEX, APARTMENT, CONDO, TRAILER, OR WITH YOUR PARENTS?

IS ANYONE IN YOUR HOUSEHOLD ALLERGIC TO DOGS?

ARE ALL MEMBERS IN THE HOUSEHOLD INVOLVED IN THE ADOPTION PROCESS AND GIVE CONSENT TO ADOPT A DOG OR PUPPY? 

DO YOU HAVE A COMPLETELY FENCED IN YARD? 

IF SO, HOW TALL IS THE FENCE AND WHAT KIND IS IT?

IS SOMEONE HOME DURING THE DAY TO TEACH A PUPPY HOUSETRAINING ETC? 

HOW DO YOU PLAN TO HOUSEBREAK THE PUPPY? 

HOW MANY HOURS PER DAY WILL THE PUPPY BE LEFT ALONE WITHOUT HUMAN COMPANIONSHIP? 

HOW MANY HOURS PER DAY WILL THE PUPPY BE LEFT ALONE WITHOUT A POTTY BREAK? 

WHEN YOU ARE AWAY FROM HOME, WHERE DO YOU PLAN TO KEEP THE PUPPY? (CRATE, KITCHEN, LAUNDRY ROOM, BACKYARD, ETC.)

WHERE WILL THE PUPPY SLEEP AT NIGHT? 

WHERE WILL THE PUPPY SLEEP ONCE HE OR SHE IS HOUSEBROKEN?

ARE YOU WILLING TO TAKE YOUR DOG TO OBEDIENCE CLASSES?

WOULD YOU BE WILLING TO ALLOW A SECOND CHANCE VOLUNTEER VISIT YOUR HOME PRIOR TO ADOPTION?

ARE YOUR CURRENT PETS SPAYED OR NEUTERED? 

ARE YOUR PETS CURRENT ON SHOTS, HEARTWORM PREVENTION, AND FLEA/TICK PREVENTION? 

WHAT IS THE BRAND NAME OF THE HEARTWORM PREVENTION YOU GIVE YOUR CURRENT DOG(S)? 

HOW MANY ADULTS LIVE IN THE HOUSE? PLEASE LIST THEIR AGES. 

HOW MANY CHILDREN LIVE IN THE HOUSE? PLEASE LIST THEIR AGES. 

IS YOUR CURRENT DOG MOSTLY INDOOR, EQUALLY BOTH INDOOR AND OUTDOOR, OR MOSTLY OUTDOOR?

WOULD THE DOG YOU ARE INTERESTED IN ADOPTING BE MOSTLY INDOOR, EQUALLY BOTH INDOOR AND OUTDOOR, OR MOSTLY OUTDOOR? 

HAVE YOU EVER GIVEN AWAY A PET AND WHY? 

IF YOU MOVE IN THE FUTURE WHAT WILL YOU DO WITH YOUR PETS? 

PLEASE LIST VET REFERENCE(S) AND PHONE NUMBER(S) FOR ALL PETS LISTED ABOVE. 



BY SIGNING BELOW, I CERTIFY THAT THE INFORMATION I HAVE GIVEN IS TRUE. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS ON THIS APPLICATION.


ELECTRONIC SIGNATURE: