Your First Name

Your Last Name

Address

Cell Phone Number

Do you accept text communication

Home Phone Number If applicable

Email Address

Please list all names & ages of household members including children & your own.

What is the work status of each member in the home?

Have you ever adopted a rescue dog before?

Have you owned a springer before?

Have you adopted from SSRI before?

What is your reason for wanting to adopt a springer?

What characteristics/personality are you looking for in a springer?

Home Info

What type of residence do you live in?

Do you own or rent? (Renters must provide a letter from the landlord stating that you are able to have this type of dog)

How long have you lived at this residence?

What is the approximate size of the yard?

Is the yard fenced?

What type of fencing?

What height is the fence?

Do you have a pool/spa?

Is there a patio?

Is the patio shaded?

Do you have a dog door?

If you have a dog door will your dog have access to the yard when you are gone?

Do you have a dog run or kennel?

Will your adopted dog be permitted on your furniture?

Will your adopted dog be permitted on your bed?

Where will your dog sleep at night?

Are there any areas of the house your Springer will not have access to?

Are there any children that visit? How often? Ages? Comfort level with dogs?

Pets

Please list type of pet, gender, age and name of all current animals in the home.

Please list type of pet, gender, age and name of previous animals.

Are there dogs that visit the home?

What is the breed and age of each dog that visits the home?

Dog Knowledge

What training techniques have you found successful?

Have you used a trainer in the past?

Do you plan to use a trainer with your adopted dog?

Have you used crates in the past?

Are you open to using a crate with your adopted dog?

What leash system have you used that you found successful?

What daily exercise will you be able to provide your springer?

How much time per day do you have to exercise your springer?

Tell us how active your lifestyle is. Do you walk? Daily? For how long ( miles & time)?What other activities?

How many hours would your adopted dog be left at home alone?

How many times a week?

Where will your dog stay if you are away from home on vacation?

Please list what issues you have dealt with in the past with dogs & how you handled these issues. For example, counter surfing, resource guarding of people, toys, food, etc.

What is your experience with prey drive in dogs?

Vet Information: Please call your vet to give them permission to speak with an SSRI volunteer

Name of current Veterinarian or Clinic

Phone number of current vet Veterinarian or Clinic

If you have gone to this vet for 2 years or less, please provide the name and phone number of the previous vet.

Please list what medical issues you have dealt with in the past.

How often do you think a Springer needs to be groomed?

How often do you take your dog to a vet?

Logistical Information

What age range will you consider?

Are you looking for a male, female or open to either?

Are you looking for a specific coloring? If so, please state.

Are you interested in a Field, Bench or open to either?

What weight range are you looking for?

Would you consider a senior Springer (10+)?

Would you consider a Springer mix?

Would you consider a dog with medical issues? For example: limited vision, hearing, diabetic

How far are you willing to travel to adopt a Springer?

Is there anything else that you would like us to know? Please specify.