YP Puppy Rescue
Charity Licence - CCP 2425

Dog Pre-Adoption Questionnaire

Just type over the If Applicable (if needed) and or Please Advise as we have made sure that all box's are completed by default with the blank ones mandatory. Thank You.

* = Mandatory Fields

Contact Information

Given Name(*)
Please add a value for Name.

Please add a value for Surname.

Phone No Day

Daytime telephone number

Phone No Night

Evening / Night time telephone no

Email Address(*)
is not a valid e-mail address.

Mobile No

Address (Please include Postcode & Council)(*)
Please add a value for Address.

Address where animal will be housed (Please include Postcode & Council)

Postal Address

Postal Address (if different to above)

Adoption for(*)

Please add a value for Adoption for.

Who are you adopting the animal for?

Adopt other

If another person, name of person

Animal Information

Dog or Cat

Invalid Input

Applying for a Dog or Cat ?

Animals name(*)
Please add a value for Dog name.

Which animal are you hoping to adopt?

Please add a value for Reason.

Please provide some information on why you would like to adopt and why you think this animal will be right for you.



Please add a value for Employed.

Are you currently employed

Type of Empl.(*)

Please add a value for Type of Empl.

Type of employment

Other Employment

Exercise, Activities & Characteristics


How much exercise would you and your dog enjoy together?


What weekend activities would you expect to enjoy with your dog?

Good Characteristics

What are the characteristics you most look for in a animal?

Bad Characteristics

What are the characteristics you would least like in a animal?


Previous pets(*)

Please add a value for Previous Pets.

Have you had pets previously in your adult life?

Other pets(*)

Please add a value for Other pets.

Do you currently have any other pets

Other pets

If yes, please give details of current pets

Animals vaccinated(*)

If you have animals, are their vaccinations up to date? A copy of current vaccination certificate may be required.


How do your current pets get along with other animals?


Have you had previous experience in any of these?

Obedience club

If yes to Obedience Classes, please provide the name of the club.

Living Arrangements


Please provide the names and ages of the regular occupants of the household.


Is anyone in the household allergic to animals

Allergy info

If yes, please provide details


Who will generally be responsible for the care of the animal.

In Agreement(*)

Is everyone in the household in agreement about adopting a animal.

Home ownership(*)

Do you own or rent your home? If renting, a written letter of approval from the Landlord must be provided, within 1 week from the date of this application, or the application will be withdrawn.


What kind of yard and fencing do you have?

Daytime location(*)

Where will your animal be during the day? Inside or Outside and what type of shelter is provided if outside ?

Night location(*)

Where will your animal be located at night? Inside or Outside and what type of shelter is provided if outside ?

Building type(*)

What type of building do you live in?

Building other

If Other, please explain


Are you happy for us to conduct a yard check?


How will your dog be cared for when you go on holiday?

Health, Care and Expenses


Are you aware of, and prepared for the ongoing costs involved with Animal ownership? Expenses can include: yearly vaccinations, food, worming, flea treatments and unexpected Vet bills.

Additional Information

Rehome pet(*)

Have you ever had to rehome or give away a previous pet?

Rehome info

If yes, please explain

Current vet

If relevant, please provide your current Vet's name



Vet for this animal(*)

Will this be the vet for this animal?

Alternate vet

If no, please provide the details of the proposed vet.


Alternate Vet's address


Alternate Vet's Phone Number if applicable.


If you adopted from us, would you be willing to provide occasional updates (emails and/or photos) as to how your pet is adapting to life with you?


Any further comments you would like to include?

Where you Heard of YP Puppy Rescue

Please advise where you heard about YP Puppy Rescue.

Anti Spam(*)

Please type what is listed above.


By submitting this questionnaire, you agree that ALL the information you have provided is correct. You understand that providing untruthful answers or failure to comply with the requirements of this application can result in the refusal of this adoption. You understand that in some instances a property check will be required. We reserve the right to refuse any applicant.

2018 Calendar

2018 Calendar - Moonta Dog Obedience Club

All profits from the sale of these Calendars will go to YP Puppy Rescue

All Dogs featured for the Month's in this Calendar are much loved companions, belonging to members of the Moonta Dog Obedience Club.

Calendars will be posted out ASAP.

View more Photos that are featured in the Calendar

Place order