Rescues Rock Adoption Application
Canine Companion
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Dog
Name
Breed
Is this dog a gift? If so, is it a surprise?
Have you ever surrendered a dog to a shelter, rescue or vet? For what reason?
Do you plan to breed this dog?
Do you currently live with any companion animals? If "YES" please describe (age, breed, energy level) If "NO" have you ever owned a dog, please explain.
Are your current companion animals up to date on their vaccinations?
Your Housing Scenario
Please Select
House
Condo
Town House
Apartment
RV
If House, Condo or Townhouse:
Please Select
I have a fenced yard
I have a fenced patio
Renters:
N/A
I have written permission from landlord/ my lease allows for a dog
I can obtain written permission from landlord for a dog
Renters:
N/A
There is no weight or breed restriction in my lease
There are restrictions, but the dog I am interested in is acceptable
Do you have children in your home, if yes, please list their ages
Describe Your Lifestyle
Please Select
Very Active
Active
Moderately Active
Not Active
ADA
How Will Your Dog Get Its Exercise?
Name of your veterinarian or veterinarian you plan to consult on your dog's health
What are your thoughts on dog/puppy training?
What have you done to prepare for your new dog/puppy ?
How many hours a day will your dog be left alone?
Will you leave your dog in a crate when you are not home?
Do you have set times you will feed your dog, or will you "free feed" (leave food out all day)?
Thoughts on dog walkers, dog day care and pet sitters?
Where will your dog stay when you travel?
What are your thoughts on Pet Insurance? Pet savings account?
Do you have a monthly budget for pet food, treats, medical/supplements?
How do you plan to treat for fleas/ticks?
Do you, your family members or roommates have allergies or take issue with pet hair?
What behavior in a dog do you consider unacceptable?
Under what circumstances would you give up your dog?
Are you prepared to begin Rescues Rock's Adoption Process in the next 3-7 days? The process involves an interview, home check and meet & greet with the dog you are interested in adopting?
Submit
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