Willing Hearts Dalmatian Rescue


Our Heart is in the Right Spot

Adoption Questionaire


We appreciate your interest in our breed. Please complete the following so that we may know you better. Your application will be reviewed and the foster mom of the Dalmatian you are interested in will contact you.

If you have any problems completing this form or just have a question, please email us at: willinghearts@mailcity.com or call us at: (610)948-5898.

If you prefer, we can also mail you an application just fill out the address information and e-mail it, or snail mail it to us at

Po Box 11
Royersford, PA 19468


Adoption Questionaire

How did you find this Web site?
Date
Name
Street Address
City, State, Zip
Home Phone
Work Phone
Best Time to be Contacted

Why do you want to own an Dalmatian?

What do you know about Dalmatians and where did you get your knowledge?

Do you consider yourself/family to be active in such a way that it would include your Dalmatian? yes no

Please Explain

What dogs do you currently have? Breed M F Age
What dogs have you had? Breed M F Age

How do your dogs get along with other dogs?

Is/are your dog(s) neutered/spayed? yes no
Have you ever breed a litter? yes no
Ever train in obedience? yes no
Are you willing to train in obedience? yes no
What dog food do you use?
How Often?
Wet or Dry?
Do you own any cats? yes no
Are they used to dogs? yes no
Name of Veterinarian
Veterinarian Address
City, State, Zip
Veterinarian Phone
Size of yard?
Fence Height?
Fence type?
If you do not have a fence, how will the dog be let in and out?
Is there an enclosure attached to the house? yes no
is the yard completely enclosed? yes no
What kind of shade enclosure?

What kind of accommodations do you have for the dog in the cold?

Is anyone home during the day? yes no
How many hours would the dog be left alone?
Where will the dog stay during the day when alone?
Do you have a dog door into the house or garage? yes no
Do you own or have you used a crate?
What do you do with your pets when you go on vacation?
What are the ages of children in contact with the dog?
Is there any asthma or allergies in the household to dogs or cats? yes no

How severe?

Please describe any neighbors that the dog would be involved with (do they like dogs?, have children(ages), have dogs or cats?)

Are there any problems with the neighbors currently? yes no

Please Explain

Do you own or rent?

If you rent please forward a letter of permission from your landlord to have a Dalmatian.
Name of Landlord
Landlord's Address
City, State, Zip
Landlord's Phone
Please specify what age/sex/color Dalmatian you are looking for (if there is a preference)
Do all parties (if more than 1 adult in the house) want a Dalmatian? yes no

Do you have any questions about the breed that we can answer?

Adopted pets need an adjustment time. Are you willing to give the new dog at least one month trial to ensure proper adjustment? yes no

What would, in your opinion, constitute a reason for not keeping the dog?

Would you consider adopting a second Dalmatian at a future date? yes no
We are always in need of temporary homes for our rescue dogs. Would you be willing to foster a needy Dalmatian if it is compatible with your lifestyle and other pets?
For how long? Until placed?

Please enter any comments or questions here:

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