White County Animal Wellness Center Adoption Survey

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* 1. Which animal are you interested in adopting?

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* 2. What age range do you prefer for your new pet?

Puppy/Kitten

Young

Adult

Senior

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* 3. What qualities are you looking for in a pet? Select all that apply.

Friendly

Playful

Calm

Independent

Good with children

Good with other pets

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* 4. Do you own or rent your home?

Own

Rent

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* 5. Do you currently have other pets in the home? List pets and ages.

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* 6. If you have current pets, provide the name and phone number of your Veterinarian.

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* 7. Are you familiar with the responsibilities involved in pet ownership?

Very familiar

Somewhat familiar

Not familiar

White County Animal Wellness Center Adoption Survey

Question Title

* 1. Which animal are you interested in adopting?

Question Title

* 2. What age range do you prefer for your new pet?

Question Title

* 3. What qualities are you looking for in a pet? Select all that apply.

Question Title

* 4. Do you own or rent your home?

Question Title

* 5. Do you currently have other pets in the home? List pets and ages.

Question Title

* 6. If you have current pets, provide the name and phone number of your Veterinarian.

Question Title

* 7. Are you familiar with the responsibilities involved in pet ownership?

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* 8. Please provide your full name.

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* 9. Please provide your email address for further communication.

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* 10. Please provide your phone number.