SCITUATE ANIMAL SHELTER
Phone Number: 781-544-4533
Fax Number: 781-544-4535
780 Chief Justice Cushing Highway
Scituate, MA 02066
Puppy Match Maker Survey - Let’s find the perfect dog for you
In order to help guide you to a dog that will best match your lifestyle, please complete
the following survey.
Your Name:*
Email :*
Phone:*
I have owned a puppy
before? (under 1 year)
Yes |
No
Currently
If yes, how long ago?
1-10 Years ago
10+ Years ago
Children under the age of 4
Children between the ages of 5 and 10 yrs
Children over 10 years old
Other dogs, familiar and unfamiliar
My puppy needs to be good
Other Animals (Specify Below)
with:
Are there any dogs currently
Yes
in the household?
No
If so, please list ages,
genders, and sizes:
Yes
Are there any cats currently
in the household?
No
Walking once or twice a day on leash
around the neighborhood (either my myself of
by a dog walker)
Running daily with me
Walking on weekends only
I will exercise my dog by:
Playing in backyard
On a scale of 1-5, how
energetic do you want your
puppy to be? (1 being laid
back, 5 being very energetic)
On a scale of 1-5, you want
your dog to be, 1 lap dog – 5
Independent
In a yard with a solid fence
In a yard with and electric fence
On a tie-out or runner
On a leash and accompanied by a member
When outside, my dog will
be:
of the family
Off-leash
4 hours or less
My dog needs to be able to
4 – 8 hours
be alone (per day):
8 – 10 hours
In a crate in the house
In a yard
Loose in the house
When I am not at home, my
Other (please explain)
dog will spend his/her time:
Are you willing to get a dog
walker if you will be gone
Yes
more than 4 hours at a time?
No
Would you consider a dog
who may bark a lot when
Yes
they are alone?
No
Puppies are NOT
housebroken, are you
comfortable with a house
Yes
training?
No
The puppy will require
training. Is everyone is your
household willing and able to
Yes
train the puppy?
No
Attending Puppy K is a
requirement to adopt the
puppy. Are you willing to
Yes
continue training if your dog
Maybe
develops behavioral issues?
No
Please tell us anything you
would like to know about
your household and
Veterinarian Contact Information: (current and past):
Do you rent or own your property? RENT
OWN
If you Rent, provide your Landlords’s contact information:
Thank you for taking the time to help us “match” you to the right pet. We look forward to working with you!