POODLE RESCUE SERVICE
- Home Evaluation -

 

 

 

 

Date:___________________

This questionnaire is prepared for your benefit, the prospective owner, and the Poodle that you
plan to have become a part of your family. Please answer the following questions and return this
form at your earliest convenience so that you can be placed on a waiting list for a rescued dog.

  Name:_____________________________________________________________________________
  e-mail:__________________________________________________________________
  Address:___________________________________________________________________________
  City:____________________________________________________State & Zip:_________________
  Phone:__________________________________Occupations:_________________________________
   
1.
Why do you want a Poodle?_____________________________________________________________
2. What variety of Poodle do you want? Standard, Miniature, Toy, any variety?_________________________
3. Have you ever owned a Poodle before?______ When?________________________________________
What variety?__________________________Where did you get it?_____________________________
4. What happened to him/her?______________________________________________________________
5. How many children at home?________ Ages?_______________________________________________
6. Who will be responsible for the Poodle?____________________________________________________
7. Do you rent?____Own a Home?____Apartment?____Are you moving?____________________________
8. Does your lease allow pets?____If moving, when ________________ Where_______________________
__________________________________________________________________________________
9. Do you have a fenced yard? ____________________________________________________________
10. Is the dog to be fenced in or let loose?______________________________________________________
11.

Do you intend to keep the dog primarily indoors or out? Please elaborate____________________________
___________________________________________________________________________________

12. Any allergies to pets?__________________________________________________________________
13. Do you have other pets?_____What kind and sex?____________________________________________
___________________________________________________________________________________
14. Where did you get your pet?_____________________________________________________________
How long have you had him/her?__________________________________________________________
15. If you don't have a pet now, have you had a pet before?________________________________________
What kind and sex?_____________How long did you have him/her?______________________________
What happened to him/her?_____________________________________________________________
16. Are you aware of the grooming requirements of poodles?______________________________________
17. Have you discussed with your family the pros and cons of owning a Poodle?________________________
18. Have you asked yourself whether your lifestyle is so busy that you might not have the time or energy to
properly care for a dog?_______________________________________________________________
__________________________________________________________________________________
19. Does everyone in your family want a dog?__________________________________________________
20. What other breeds have you been contemplating?____________________________________________
21. What is your family's overall reaction to owning a dog?________________________________________
22.

Do you realize that a Poodle may live for 10-18 years and are you committed to care for it that long?
_________________________________________________________________________________

23. Are you willing to attend obedience classes to train the dog?___________________________________
Which family members would be expected to assist with home training?___________________________
24. Do you have a sex preference?________Which?___________________________________________
25. Would you consider the opposite sex?____________________________________________________
26. Would you be interested in an older dog?__________________________________________________
27. Are you agreeable to returning the dog, should some unforeseen circumstance arise wherin you would no
longer be able to keep the dog?________________________________________________________
________________________________________________________________________________
28. How did you find out about us?_________________________________________________________
29.

Your comments and suggestions:_______________________________________________________
________________________________________________________________________________
   
 
Thank you for your cooperation.
This comprehensive questionnaire helps us in placeing the right dog with the right family.


Your Signature:______________________________________________Date:__________________

Please mail this form to:

Paula Waterman
1334 Hillcrest Dr
Eldersburg, MD 21784