Florida Cocker Spaniel Rescue - Florida Cocker Spaniel Rescue

We sincerely hope we can be of service to you.

We ask that you fill out this questionnaire as completely as possible.

This form is designed to help you help us in finding the Cocker Spaniel most compatible with your lifestyle. Our ultimate goal is to match the right dog with the right home for the enduring happiness of both you and your new best friend.

IF YOUR APPLICATION IS ACCEPTED YOU WILL HEAR BACK FROM US.
WE DO NOT SHIP OUT OUR DOGS!

Just complete this form. and click the "Submit" button at the bottom when ready to send.
Make sure your email address is correct and the vet reference and heartworm questions are answered.

Florida Cocker Spaniel Rescue - Adoption Application

Your Name

Your Email

Current Pet Information Do leave this section blank. If you don't have a pet at this time, please type "None"

Vet Info

Please provide your veterinarian's name, address, and phone number.

Heartworm

What is the name of the Heartworm Preventative you are now using.

Flea Control

What type of flea control do you use?

Primary Adopter's Information

Address

City

State

Zip Code

Home Phone

Business Phone

Cell Phone

Occupation

Employer

Drivers License

Other Information All of this information is important. Please fill in as many fields as you can.

Adults

Please list the ages of the adults living in the household.

Children

Please list the ages and sex of the children living in the household or those who will have regular contact with the pet.

Owned Cocker Yes No

Have you owned a Cocker Spaniel before?

Why Want Cocker

Please explain why you want a Cocker Spaniel.

Pet History

Please list all the pets that you have owned in the past 10 years. If none, include pets owned during your adult life and any pet residing in your home that you didn't own.

Pets Neutered Yes No

Have your Current/Previous Pets been spayed/neutered?

Sold Details

If you have ever sold or given away a pet or surrendered one to a shelter, please explain why.

Live In

Select the type of residence that you live in.

Landlord

If you rent or lease, you must have written permission from your landlord. Please list landlord's name and contact information.

Fence Description

If your yard is fenced, please describe the fencing (what part of yard, height, type, etc.)

Consider Fence Yes No

If your yard isn't fenced, would you consider fencing part or all of it as a condition of adoption?

Modify Schedule Yes No

Are you willing and able to modify your daily schedule to accomodate a Cocker Spaniels needs, such as going outdoors into a fenced area or walking on a leash to perform bodily functions at least 4 times a day?

Importance of Leash Yes No

Are you aware of the importance of keeping a Cocker Spaniel on a leash or in a fenced area when it goes outside?

Working Hours

What are the working hours of the adults in the house?

Where Kept

Where will the dog be kept when you are home?

Where Sleep

Where will the dog sleep at night?

Dog Sleep With Yes No

Are you opposed to the dog sleeping with you?

Where Kept Alone

Where will the dog be kept when left alone?

Allowed on Furniture Yes No

Will the dog be allowed on furniture?

Who Responsible

Who will be responsible for the care and training of the Cocker Spaniel?

Experience Yes No

Does he/she have any experience with dogs?:

Allergies Yes No

Does anyone in the home have allergies?

Exercise

Where and how do you plan to exercise the dog?

Supervise

Who will supervise outdoor activities?

Lifestyle

Please describe your lifestyle. Is it active? (e.g., hiking, camping, busy in the community,in and out a lot) Or is it a more relaxed, structured atmosphere? Will you include the dog in your activities?

Home Alone

This dog will be left alone (without human companionship) for how many hours a day?

Perfect Dog

Please describe the perfect dog for your home. Taking into consideration that Cockers vary greatly in temperament, personality, and activity level, what characteristics do you want in your dog? Please answer in as much detail as possible.

Undesirable

What characteristics of a dog would be undesirable?

Accept Older Yes No

Would you accept a dog that is older?

Accept Abused Yes No

Would you accept a dog that has been abused?

Accept Not Reliable Yes No

Would you accept a dog that is NOT reliable with children?

Accept Health Problems Yes No

Would you accept a dog that has a health problem (mild or major)?

Obedience Class Yes No

Knowing that some rescue dogs have had little or no training, are you willing to take the dog to obedience classes?

Housebreak Yes No

Are you willing to housebreak a dog, if necessary?:

Housebreak Method

What primary method of housebreaking have you used in the past? Please describe your experience.

Handle Jumping

How would you handle adjustment/training for jumping on people?

Handle Barking

How would you handle adjustment/training for barking?

Handle Chewing

How would you handle adjustment/training for chewing?

Adjust Time Yes No

Are you willing to give the dog time to adjust to a new environment?

Pay For Grooming Yes No

Some Cockers need to be professionally groomed (approx. $50) about every 2 months. Does this present a problem?

Financial Problem Yes No

Are you willing to support a dog? The basic needs of a Cocker (feeding, grooming, shots, Heartworm protection, Flea preventative) average $800-$1,000 per year. Any special problems could increase this amount. Does this financial responsibility present a problem?:

Lifetime Commitment Yes No

Are you committed to caring for a dog for it's lifespan (Cockers can live 14-16 years)?

Comments

Please write any additional comments or questions that you may have.

How Heard

How did you hear about our organization?