PRE-HOME QUESTIONNAIRESMALL ANIMALS

Home No:

Postcode:

Mobile No:

Title: First name: Surname:

Email:

Address:

PHQSMLScottish Society for the Prevention of Cruelty to Animals, Kingseat Road, Halbeath, Dunfermline KY11 8RY | Scottish Charity No. SC 006467

Please noteWhen rehoming an animal you will need to provide printed identification with your name and address, such as a utility bill or driving licence.

This is not a booking form and does not entitle you to rehome an animal from the Scottish SPCA. The Scottish SPCA reserves the right to choose the most suitable home for animals in its care.

Home checks may be carried out to inspect the suitability of accommodation.

Data protectionWe would like to keep in contact with you. By signing this form you agree to the Scottish SPCA recording the details shown and con-sent to contact from the Society. We will not disclose this information to third parties. If you would rather not hear from us or our trading company please tick this box.

Signature: Date: / /

1 Why do you wish to take on a new animal?

What type of animal are you looking for?

Have you already identified the animal you wish to rehome? Yes No

What accommodation do you have to keep an animal in?

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Do you need permission to have a pet? Yes No14

Who would look after the animal in an emergency or if you go on holiday?21

Have you visited any other Scottish SPCA centres to rehome an animal? Yes No22

23 Are you a member of the Scottish SPCA? Yes No

Please tell us what prompted you to visit our centre?24

Scottish SPCA website

Word of mouth

Facebook/Twitter

Search engine

Television advert Radio advert Story in media

Other (Please specify)

Have you had pets before? Yes No If yes please provide details below... 4

Are you the householder? Yes No

Who else lives with you?

Do you or does anyone in your household suffer from allergies? Yes No

Do you live in a: house flat other

Is your accommodation: privately owned privately rented council

How long have you lived at this address? If less than six months please provide previous address

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If you share a communal garden, have you discussed rehoming an animal with your neighbours? Yes No 617

Who would look after the animal on a daily basis?18

How and where would the animal be exercised?19

Are you prepared to meet the costs of regular and necessary veterinary expenses, including boosters, worming, vaccinations and any emergency treatment required? Yes No

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If you rehome a pet which is not already neutered/spayed, would you agree to have this procedure carried out?

Yes No

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Do you have a garden? Yes No Communal 15 16 If you have a garden, is it enclosed? Yes No

Do you own other animals at the moment? Yes No If yes please provide details below... 5

Are they neutered/spayed Yes No