Check the following events that have either occurred in your life in the last 6 months, as well as those that you anticpate may occur in the next 6 months:

• Recently married, or planning an upcoming wedding
• Experiencing the divorce or end of a relationship
• Current financial concerns
• Expecting a child (pregnancy or adoption)
• Do you have children younger than 5 years of age?
• Do you anticipate moving to a new residence or did you recently move?
• Does your residence have pet breed or size restrictions?
• Are you currently or planning on doing extensive rennovations to your residence?
• Do you anticipate any change to your current living arrangements (roommate moving in or out, etc.)?
• Has there been a change in status of a family member, or do you anticipate one? (new job, etc.)
• Have there been, or do you anticipate any changes in family routine?
• Do you plan on leaving town for any reason (work or family) within the first month of adoption?
• Do you travel frequently, either for business or pleasure?
• Do you have children leaving home or moving back home (particularly with children or pets)?
• Do you have care-taking responsibilities for an elderly or ill family member?
• Do any of your family members have allergies, illness or compromised health issues?
• Have you recently experienced the death of a family member?
• Have you experienced the death or disappearance of a family pet in the last year?
• Have you had to give away a pet to a relative or friend, or surrender a pet to an animal shelter?
• Is this a pet for a family member who has not been consulted?
• Is this an impulse decision (it is so cute, begging children, etc.)?
• Has there been disagreement amongst family members regarding adopting a pet?
• Has there been disagreement amongst family members regarding what type of pet to adopt
  (cat, dog, boy, girl, etc.)?

How many pets do you currently own?

• 0
• 1
• 2
• 3
• 4
• 5