Adoption Application

Adoption Application

Once your application is received you will be contacted by a representative of Rescue Rehome Repeat of South Louisiana. If you are not contacted after 48 hours the pet you applied for may no longer be available. You may call 225-788-6940 after 48 hours for further assistance.
NOTE: We are unable to adopt dogs to residents living outside of the state of Louisiana.
Full Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number*

Area CodePhone Number
Cell Number

Area CodePhone Number
How do you want us to contact you?

EmailText MessagePhone Call
Are you 21 or older? You must be 21 to adopt through Rescue Rehome Repeat.

YesNo
Birthdate*

MonthDayYear
Date
What is the name of the pet you want to adopt (please write the name of the pet you saw on our PetFinder pages, Facebook or on our website. If you don't have a specific pet in mind please let us know the date of the event you will be attending.*
Why do you want to adopt a pet?*
Have you ever been turned down for a pet adoption by any animal welfare group, shelter or other adoption agency?*

YesNo
Who are you adopting this pet for?*
How many people live in your home?*
Please tell us what previous experience, if any, you have with dogs.*
Are there any children in your home? (Note: Depending on which pet you are applying, you may not be able to adopt with children under five years of age living in your home.)*

YesNo
Ages of Children
Will you be be willing to buy a wire crate, if necessary?*

YesNo
List veterinarian/animal clinic where your current pet receives care. If you do not have a pet currently, list your previous veterinarian/animal clinic you used. A veterinarian reference is mandatory to adopt from our organization through our online application process. If this is your very first pet and you have never had a veterinarian before, some restrictions may apply. *
Enter phone or contact information for vets/animal hospitals you have used. (Enter NONE if not applicable.)*
What are the names, breeds, and sex of your current pet(s)?*
What name are your vet records under? *
Do we have your permission to inquire/receive your veterinary records?*

YesNo
If you give us permission to reach out to your vet, we need you to contact your vet now to release records to us.*

I have contacted my vet and given them permission.
If you have not called and released your records, your application will automatically be denied.*

I understand.
What type of home do you live in?*
Do you Rent or Own?*
Do you have a fenced yard? This means a secure, fully fenced area, in some cases 5-6 feet tall minimum depending on pet, may be required.)*

YesNo
Would you leave your pet unattended in the yard?*

YesNo
Do you plan to move in the near future?*

YesNo
How many hours per day will the pet be left alone?*
Where will the pet sleep?
What provisions will you make for this pet when you go on vacation?
Are you aware that we require all pets in your home be spayed or neutered?*

YesNo
Are all your current pets spayed or neutered?*

YesNo
Do you have any allergies or medical conditions that would make it difficult to own or care for this pet?*
Do you consent to a home visit if needed?*

YesNo
Are you aware the adoption fees for dogs can range from $150-500 for canines? and that all adoption fees are considered non-refundable donations?*

YesNo
Please use this area to make any comments you feel will help us process your adoption application.
How did you find Rescue Rehome Repeat?*

Petfinder.comFacebookTik TokTwitterInstagramFriend or FamilyWAFBWBRZOther
By checking this box I agree to all the above terms.
Please verify that you are human*
If you are applying for a “groom dog” such as a Poodle, Doodle, Maltese, bichon, schnauzer, etc. please list your groomer’s name and number.
Should be Empty: