Adoption Questionnaire 領養問卷

Not all homes are suitable for keeping a dog. Have you considered the reality of
adopting a dog? ONLY if you are sure that you can offer a dog a loving and permanent home, please complete the following questionnaire which will allow us to assess which type of dog would best suit your home and lifestyle.

There is a standard non-negotiable adoption fee payable which goes towards covering the basic veterinary costs of licensing, microchip, rabies vaccination, heath check including heartworm test, vaccination, de-worming and de-sexing as applicable.

*Adopter must be 25 years old or above.

Hong Kong Dog Rescue has been granted an exemption from holding an animal trader licence in accordance with regulation 5A(1) of the Public Health (Animals and birds) (Trading and Breeding) Regulations, Cap. 139B.
Exemption number: ORG-00001

並非所有家庭都適合領養狗隻。你可有認真考慮過領養狗隻所需的條件和帶來的轉變？如果你確定能夠為狗隻提供一個安穩﹑舒適和長久的家，請填妥以下問卷，讓我們評定哪種狗隻最適合你的居住環境和生活方式。

領養者必須負責支付由本會規定的領養費用，以支付狗隻的一切基本醫療支出，包括牌照、晶片、狂犬病注射疫苗，健康檢驗(包括：心絲蟲、防疫注射、杜蟲)及絕育手術（如適用）。

*領養者需年滿25歲。

救狗之家已獲豁免根據第139B章《公眾衞生(動物及禽鳥)(售賣及繁育)規例》第5A(1) 條需持有的動物售賣商牌照。
豁免編號: ORG-00001

PLEASE THINK BEFORE ADOPTING　領養前務必考慮清楚

Name 姓名 *

First Name Last Name

Address (proof of address will be required) 地址(需提供住址證明): *

Email 電郵地址: *

Mobile Phone Number 手提電話號碼 *

Home Phone Number 住宅電話號碼

Age (if under 25) 年齡 (如未滿25歲)

Age (Applicant must be over 21 years old) 年齡 (申請者必須年滿21歲) *

Below 21 21歲以下 21 or above 21歲或以上

Are you a HK permanent resident? 你是否香港永久居民？ *

Yes 是 No 不是

Have you discussed adopting a dog with all household/family members (including your helper)? 你有否與家人(包括家務助理) 討論計劃領養狗隻? *

Yes 有 No 沒有

Are you looking for a dog to be 你期望領養的狗隻會成為︰ *

Family Member 家庭成員 Guard Dog 看門犬 Child(ren)'s Pet 孩子的寵物 Senior's Companion 家中老人的良伴

What size of dog are you looking for? 你想領養體型多大的狗隻? *

Small (under 10kg) 小型 (10公斤以下) Medium (around 10kg-20kg) 中型 (約10至20公斤) Large (around 20kg-30kg) 大型 (約20至30公斤) Giant (over 30kg) 巨型 (30公斤以上)

What age? 你想領養甚麼年紀的狗隻? *

Puppy 幼犬 Young adult (up to 1 year) 年輕成犬(至1歲) Adult 成犬 Senior 年長

What character? 你想領養什麼性格的狗隻? *

Independent 獨立 Needy 倚賴 Energetic 精力旺盛 Quiet 文靜 Playful 愛玩耍 Laidback 悠閒 Social 喜歡交際

What kind of coat are you looking for your dog to have? 你想領養長毛或短毛的狗隻? *

Long 長毛 Short 短毛 Either 兩者皆可

Type of home　住宅類别 *

Apartment　大廈 House獨立屋 Self Owned 自置 Rented 租住

Size 面積 (Sq. ft.平方呎) *

Outside Area 室外設施 *

Garden花園 Balcony露台 Patio平台 Roof天台 Nil 無

Size 面積 (Sq. ft.平方呎)

Are Pets Permitted In Your Building? 所住大廈是否容許飼養狗隻? *

Yes　是 No　否 Don't know　不知道

If you are renting, does your landlord agree to you having a dog?　如目前居所為租住性質，單位業主是否已同意讓你飼養狗隻？ *

Yes　是 No　否 Don't know　不知道

Number of people living in home 在家居住人數 : *

Number and age of child(ren) 小孩人數及年齡（Please input N/A if not applicable 如不適用請填 N/A）： *

Domestic helper 家務助理: *

Yes 有 No　沒有

If yes 如有,

Full　全職 Part Time　兼職　(How often? 次數及時間?）

Is anyone in your home allergic to dogs? 家中有沒有人對狗隻敏感？ *

Yes 有 No　沒有

Who will be mainly responsible for the care of the dog? 誰將主要負責照顧狗隻? *

If you will leave your dog in the care of a helper, are you confident that your helper is responsible and knowledgeable enough? 如你需要把狗隻交由家務助理照顧，你是否肯定家務助理有足夠責任感與知識照顧狗隻？

Yes　是 No　否

Do you currently have other dogs? 現時有沒有飼養其他狗隻? *

Yes 有 No　沒有

IF YES 如有: Type 品種 / Size 大小 / Sex 性別 / Age 年紀 :

Desexed? 有否絕育?

Yes 有 No　沒有

Licensed? 有否領有狗隻牌照?

Yes 有 No　沒有

Vaccinated against infectious diseases? 有否接受防疫注射?

Yes 有 No　沒有

On heartworm prevention? 有否預防心絲蟲?

Yes 有 No　沒有

Given flea/tick prevention? 有否預防牛蜱/跳蝨?

Yes 有 No　沒有

Which vet clinic do you take your animal to? 你帶牠看哪位獸醫?

If you don't have a dog now, have you ever had a dog before? 如你目前沒有養狗，以前有否飼養過狗隻? *

Yes 有 No　沒有

IF YES, Please give details of type, age, when and what happened to the dog(s). 如有，請列明品種、年紀、飼養年期及牠因何離開。

Do you currently have any other pets? 現時有沒有其他寵物? *

Yes 有 No　沒有

If YES, please specify 如有，請列明資料

Are all household members at work during the day?　是否所有家人都在日間工作? *

Yes　是 No　否

How long would a dog be left alone daily? 狗隻每天會有多長時間獨留在家? *

Where will the dog be kept during the day? 狗隻在日間住在哪裡? *

Inside Free　家裏自由走動 In Cage/Crate　籠内 Garden　花園 Roof　天台

Where will the dog sleep at night? 狗隻於晚上在哪裡睡? *

Inside Free　家裏自由走動 In Cage/Crate　籠内 Garden　花園 Roof　天台

Where will you keep the dog when he is alone? 當狗隻獨處時，你會把牠安置在何處? *

Inside Free　家裏自由走動 In Cage/Crate　籠内 Garden　花園 Roof　天台

How often will you take the dog for a walk? 你多久會帶牠出外散步? *

For how long　每次散步多久? *

Where　去哪裡散步? *

Street　街上 Park　公園 Countryside　郊外

Would you be willing to have training with the dog? 你是否願意與狗隻共同參與訓練? *

Yes　是 No　否

Do you understand what is meant by “positive” training? 你明白了解甚麼是「正向訓練」? *

Yes　是 No　否

Would you be able to handle problems such as chewing, barking, jumping, house-soiling? 你是否能够處理狗隻帶來的問題，如：咬傢俱、吠叫、跳撲、於家中隨處便溺等? *

Yes　是 No　否

Do you understand that these dogs may have been abandoned and may need time to adjust to a new home? 你是否明白這些狗隻因曾遭遺棄，故可能需要一些時間適應新環境？ *

Yes　是 No　否

Are you willing to be patient and give the dog at least ONE MONTH to adjust to your family and environment? 你是否有足夠耐性，給予狗隻最少一個月時間適應與你的家人相處和新居環境? *

Yes　是 No　否

Do you understand that the dog/puppy you are adopting is required to be desexed if not already done? 如你領養的狗隻尚未絕育，你是否明白稍後必須為牠進行絕育? *

Yes　是 No　否

If you are adopting a puppy, do you understand that puppies may chew your shoes and furniture, and bite with sharp teeth? 假如你想領養幼犬，你是否明白幼犬可能會嚼咬皮鞋及傢俱，也可能會以利齒咬其他物件或人? *

Yes　是 No　否

A dog’s life span is usually around 15 years. Can you commit to keeping a dog for that long? 狗隻的壽命通常約為15年，你能否承諾照顧牠終老? *

Yes　能 No　不能

If not, would you consider adopting an older dog? 假如不能，你會考慮領養年紀較大的狗隻嗎? *

Yes　會 No　不會

If you move home, what would you do with your dog? 如計劃搬遷居所，你會如何處置狗隻？

Take 一起遷居 Re-Home 另覓主人 Don’t Know 不知道 N/A不適用

Would you take a dog with you if you moved abroad? 假如你移居外地，你會否帶同狗隻一起移居？ *

Yes　會 No　不會

Have you considered how much it will cost to care for your dog each year (including the cost of food, grooming, training & veterinary care)? 你有否考慮每年需要花在照顧狗隻的費用（包括食物、美容、訓練、醫療等）? *

Yes　有 No　沒有

If you are adopting because your children want a dog, have you considered that your children will grow and may lose interest or leave home? 如你是因為孩子的要求而領養狗隻，你有否想過孩子長大後可能會失去興趣，又或會離家？ *

Yes　有 No　沒有 N/A 不適用

If you are young and single, have you considered the future possibility of moving abroad or to a new home or getting married and having children? Would you include your dog in any future plans? 假如你是年輕及單身，你有否想過將來有可能移居外地、搬遷新居或結婚生育？你的狗隻會被納入你未來的計劃嗎？ *

Yes　有 No　沒有 N/A 不適用

If you are interested in specific dogs, please provide their names. 如你對某些待領狗隻有興趣，請提供牠們的名字

Please include any additional information that would help us find that perfect family member for your home and environment. 為了讓我們找到最適合你居住環境和生活方式的狗隻，請提供任何額外資料。

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Please tick here if you wish to receive news and information about Hong Kong Dog Rescue. 如你想收到更多香港救狗之家的資訊，請在方格畫上剔號。