Pre-adoption questionnaire

Thank you for taking the time to answer our pre-adoption questionnaire. This questionnaire is essential to help us match the perfect homes for our dogs. Please answer all questions truthfully and to the best of your knowledge so we can help you find your perfect match.

1
2
3
4
5
Last Page
A few details about you
Title (Required field)
First Name (Required field)
Surname (Required field)
Date of Birth (Required field)
DD/MM/YYYY
Address (Required field)
Postcode (Required field)
Telephone number (Required field)
Email address

Alternative telephone number

(We will usually contact you between the hours of 8:30am and 4:30pm)

Please check you have completed all of the required fields.
You are interested in:
Size of dog:
Gender of dog:
Age of dog:
Is there a dog or puppy on our website that you are interested in?
(You can add more than 1 dog by clicking the button above multiple times).
At which centre is the dog or puppy you are interested in? (Required field)

A little bit about your home:
Do you (Required field)
If you rent, do you have written permission to have a dog in the home? (Required field)
Type of property (Required field)
If other, please specify
If you live in a flat, which floor is your flat on?

Do you have a garden? (Required field)
Size of garden (Required field)
Is the garden all secure? (Required field)
Height of fencing: (Required field)
Do you have direct access into your garden? (e.g. via a door or gate?) (Required field)
If no, please specify:
Please check you have completed all of the required fields.
A little bit about your family:

Who lives at home?

Number of adults: (Required field)
Number of children (if no children, please type n/a in the box): (Required field)
Ages of children:
Do you have children that visit regularly? (Required field)
If yes, what are their ages?
Frequency of visits: (Required field)
Do you own any other dogs? (Required field)
If yes, please state breed and gender
Are they neutered? (Required field)

Do you have any other pets? (Required field)
If yes, tick all that apply (Required field)
If other, please state:
Do you have any visiting animals (e.g. family/friends' cats and dogs)? If so, please give details: (Required field)
Please check you have completed all of the required fields.
A little bit about your lifestyle:

How much daily exercise do you expect to give the dog?

Weekday (Required field)
Weekend (Required field)
How active are you? (Required field)
How long do you expect to leave the dog alone on a regular basis? (Required field)
When? (Required field)
How often?
Where do you plan on leaving the dog when you leave the house? (Required field)
If other, please specify:
Are you planning on any of the following? (Required field)

Your ideal dog would:
Be good with cats
Like other dogs
Be good with livestock
Be comfortable around children
Like strangers
Enjoy being picked up/petted
Please check you have completed all of the required fields.
Previous ownership experience
Have you had dogs before? (Required field)
If yes, can you give details (i.e. Breed, Size, Gender etc.):
Please tell us a little more of your experience: (Tick any that apply) (Required field)

By submitting this form, you agree that all the information above is factual and truthful to the best of your knowledge. (Required field)

Whilst every care is taken to find the right dog for you, we cannot guarantee behaviour.

Thank you so much for your enquiry. We would really like to keep in touch with you so we can keep you updated about our work, information about adoption and information about supporting our charity.  Please select your preference below and remember you can change your mind at any time – just let us know.

First Name
Last Name
How would you like to hear from us? 

Your privacy is important to us.

The information you provide to Birmingham Dogs Home will be treated confidentially and only used in line with your instructions on this form.  We promised to protect your data and manage any data you share with us in line with all current data protection laws.  Your details will not be passed on to any third parties.  If you change your mind or do not wish us to contact you further,  please  let us know at communications@birminghamdogshome.org.uk.  

Thank you

Find the right dog for you

Size
Age Range
Gender

Suitable to live with

Centre

Or