Date:

QUESTIONS

ANSWERS

Name, last name, place and date of birth of the future

dog’s owner (whose name will be connected to the microchip):

Home address:

E-mail address:

Job:

Phone numbers (landline and mobile phone):

Time of day you prefer to be contact at:

Name and last name of your husband / partner:

Your husband / partner’s phone numbers:

Your husband / partner’s job:

1) Why do you want to adopt a dog?

2) Do you prefer a male or a female dog?

3) What do you expect from the dog?

4) What character traits would you prefer, if you could choose?

5) What age do you prefer if you could choose?

6) Have you already had dogs in the past? If yes:

 6a) if they are not with you anymore, why:

(Fostered by someone else, dead because of illness, age, other reasons)? At what age?

 6b) Did you get the previous dog(s) when puppies?

 6c) What breed was/were it/they?

 6d) Since how long have you been living without a dog?

 6e) Was/were the dog(s) neutered?

7) Do you own any dog at the moment? If yes:

 7a) how many?

 7b) male or female?

 7c) since when have they been staying with you?

 7d) what breed, what age, and what size?

 7e) neutered?

 7f) where did they come from (breeder, shelter, street, private, other)

8) How many people are there in your family?

9) How old your family members are?

10) Does each and every member agree with the adoption?

11) Are there any children?

If yes, how many and what age?

12) Are there aged family members?

If yes, how many and what age?

13) Are there any pet fur allergies in the family?

14) Is someone in the family afraid of dogs or other animals?

15) Do you have other pets at the moment

(cats, bunnies, birds or other)? If yes:

 15a) what kind and how many?

 15b) Have they ever lived with a dog?

16) Do you live in a flat?

17) Do other people in the building have dogs?

18) Do you own your flat/house or are you renting it?

19) If you live in a rented place, did you inform the owner that you are willing to adopt a dog? If yes, does he/she allow it?

20) What floor of the building do you live on?

21) Do you have an outdoor place (yard, garden, balcony, terrace, veranda, ecc.) at home? If yes, please, describe what type and size.

22) If there is a garden, is it enclosed?

23) How high is the fence?

24) Is there a concrete floor under the fence?

25) Is it possible to access the garden by car?

26) Where would the dog spend most of his/her time (house, garden, balcony, kennel)?

27) Where would the dog sleep (house, garden, balcony, kennel)?

28) What kind of accommodation would you choose for the night (kennel, doghouse, cushion, other)?

29) How many hours would the dog be alone during the day? (please, be specific telling the time)

30) How many times a day would you get the dog outside for a walk?

31) Are there in your neighbourhood any parks or enclosed areas suitable for dogs?

32) What would happen to the dog if you went on holiday? (go with you, stay at a dog daycare or with trusted friends)?

33) Who would take care of the dog if you had to go away for some reason?

34) Are you willing to drive to a distant airport to pick the adopted dog up?

35) Would you refund all the expenses that have been necessarily faced for the adopted dog, and that the adopter has to pay for when receiving the dog itself (vaccinations, anthelmintic therapy, microchip, blood tests, trip, and all the possible other costs)?

36) Would you go hunting with the dog?

37) Do you agree with neutering?

38) The neutering is mandatory. Would you neuter the dog?

39) During his/her life, the dog has to be vaccinated, treated with anthelmintic therapy and has to have yearly prevention tests – are you ready to pay for everything, also in case he/she needs to be therapized for some reason?

40) Do you know a 24h veterinarian clinic where you could take the dog in case of emergency?

41) Do you have a trusted vet? If so, please provide his/her name, phone number and address.

42) Are you okay with the fact that there could be further checks after the adoption?

43) A dog is not a children’s toy, if the dog gets hurt, he/she could react and it is necessary to constantly supervise dogs and children while playing together. Are you aware of this?

44) Do you know the character traits and the specific needs of the Cirneco dell'Etna breed?

45) Dogs need to be trained to walk on the leash, to do their business outside and how to live in their new environment. Do you have the patience to do this and to follow some basic rules concerning the training and the correct way of living together?

46) The Cirneco you are interested in could probably be a stray dog: if there were co-living problems or any difficulties with the training, are you willing to cooperate with a dog trainer and pay to solve those problems?

47) How did you get to know about the dog you would like to adopt? If it was on the internet: on what page, group, etc.?

48) If you are not able or willing to keep the dog with you anymore, are you aware that you CANNOT give it away without the consent of the association and that you have to call it immediately to get the dog back to the Association itself?

49) Are you willing to keep in contact with the Association, and with its volunteers as well, after the adoption?

By filling this questionnaire in, you authorize the treatment of your personal data according to the Italian D.L. 196/2003.

Form to be filled in by the Association (DO NOT WRITE BELOW):

Pre-adoption check done on

From

Tel.

Dog’s name

day

microchip #