Adoptability Questionnaire

Adoptability Questionnaire
for Georgia and Alabama

Please complete this online form and press the "Submit" button. The form will be sent to our owner assistance coordinator, who will contact you. If you don't hear from us after a few days, please email via ownerassist@springerrescuegaal.org .

Your Name:
Email address:
Street Address:
City:       State:    Zip:
Home Phone:
Cell Phone:
Work Phone:

Dog's Name:
Sex:
Age/Date of Birth if known:
Weight (approx):
Color/distinguishing markings:
What type of Springer?         Bench/show Field-bred   Not sure
Spayed/neutered?                 Yes      No
Tail docked?                         Yes     No

Reason for Relinquishment?

Are you the original owner? Yes No
If not, what is the dog's history?

I found this dog as a stray. If so, how long ago?

Vet's Name:
Vet's Address:
City, State, Zip:
Vet's Phone number:

Does he/she have any medical conditions? Yes No
If so, please explain:

Date of last vaccines:
Date of last heartworm test:
Is he/she on heartworm preventative?    Yes   No
Is he/she on flea/tick preventative?        Yes   No

Any history of biting? Yes No
If so, please give details:

Is the dog microchipped? Yes No
If so, what is the company and number?

Is the dog AKC registered? Yes No
Who is the breeder?

Is he/she housetrained? Yes No Not sure

Is he/she crate-trained? Yes No Not sure

Is he/she good with children? Yes No Not sure
If so, what ages? Any other comments?

Is he/she good with other dogs? Yes No Not sure

Is he/she good with cats? Yes No Not sure

Does he/she ride well in the car? Yes No Not sure

Is he/she good at the groomer? Yes No Not sure

Where does the dog stay during the day?

Where does the dog sleep?