Five Friends Animal Rescue Dog/Puppy Adoption Application and Agreement
FiveFriendsAnimalRescue.Weebly.com, Five FriendsAnimalRescue@gmail.com
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What County do you live in? (Brevard, Orange, etc..)
Phone Number
Please enter a valid phone number.
Which dog are you interested in adopting?
Your Date of Birth
How long have you lived at the address above?
How many times have you moved in the last 36 months?
Do you have a fenced in yard?
Yes
No
If you do not have a fenced in yard, what is your plan to exercise the dog?
Do you live in a:
House
Townhouse
Condo
Apartment
Other
Do you own or rent (*please note, if your name is not on the deed, you should select “rent” and provide contact information for the owner, even if the owner is a spouse, parent or other family member):
Own
Rent
If you rent (or live with someone else who owns), what is your landlord name and phone number? *Please note: Failure to include this info will result in an automatic denial of your application.
How many adults reside in your home?
Please list the first and last name for anyone over 18 that resides in the same home.
How many children reside in your home and what are their ages, if any?
Do other children visit your home? If so, how often and what ages?
Has anyone living in your home been diagnosed as allergic to dogs?
Where are you employed?
Is your significant other employed? If so, where?
If you become unemployed, how will you care for the dog?
Are all the members of the household aware and agree to the adoption of the dog?
How many hours each day will the dog be alone?
Who will be primarily responsible for the care of the dog?
Where will the dog stay when no one is home such as when you take vacation?
Will you be crating the dog?
Yes
No
If yes, how many hours a day will the dog be in a crate?
Have you ever turned an animal in to Animal Services or Animal Control? If yes, please explain.
Do you have a current vet?
Yes
No
May we contact your current vet?
Yes
No
Vet name and phone number (please provide both) ** Failure to include this information may result in an immediate denial of your application:
Would you agree to a home visit to ensure us you will be providing a safe and healthy home?
Yes
No
Do you understand that you will be sharing your life with a dog for 14-20 years, and that the dog is totally dependent upon YOU for food, shelter, health, and veterinary care?
Yes
No
Are your current pets up to date on vaccines, flea and heartworm prevention?
Yes
No
Are your current pets spayed and/or neutered?
Yes
No
Current pets. Please include name, type of animal, age, sex, if the pet is spayed or neutered, and if the pet is an indoor or outdoor animal. ** Please note failure to completely answer this question may result in a denial of your application.
Previous pets. Please list all animals you've had in the previous 5 years not listed above, including type of pet, age, spayed/neutered, and what happened to the pet?
As the adopter I agree to the following: I will care for this dog/puppy, will assume all responsibility for his/her wellbeing, and will keep him/her INDOOORS ONLY. I will never abandon, sell, trade or give away this dog/puppy, nor allow him/her to be used for experimentation or any other inhumane activity.
Please initial
I am aware that the actions of the dog/puppy are often unpredictable and understand that Five Friends Animal Rescue makes no representations regarding the behavior or temperament of any dogs/puppies for adoption. I understand that dogs/puppies need time to adjust to a new environment. I promise to keep my new dog/puppy separated in a quiet, safe place as these adjustments are made. I understand such adjustments can take 30 DAYS or longer depending on the temperaments of both new pet and resident pets.
Please initial
I release Five Friends Animal Rescue of any responsibility for damages to any person or property caused by adopting this dog/puppy. If for any reason the animal bites, FFAR will not be able to accept the dog back into the rescue.
Please initial
I will be responsible for all future medical care of this dog/puppy, and will not look to Five Friends Animal Rescue for any any reimbursement of medical bills from the date I take the animal home forward.
Please initial
I will take this dog/puppy to the veterinarian for a complete medical exam within 14 days of this adoption.
Please initial
I understand that a move to a new home may cause stress-related illnesses shortly after adoption. I will not hold Five Friends Animal Rescue responsible for any medical treatment after the date of the adoption.
Please initial
I understand all vaccines are current as of this adoption date, but he/she may require additional vaccines in the near future. I understand that puppies need a minimum of 3 DHPPC-2 vaccinations and a rabies vaccination at 5 months of age. I understand that each adult dog needs a minimum of 1 DHPPC-2 and 1 rabies vaccination annually.
Please initial
I agree to maintain HEARTWORM PREVENTION for the dog/puppy throughout its entire life. Heartworm disease is deadly if not treated. Treatment is expensive and physically taxing on the dog. I UNDERSTAND THAT PREVENTION OF THIS DISEASE IS A REQUIREMENT OF ADOPTION.
Please initial
I am aware that medical care for my new dog/puppy can vary widely in both quality and costs. I will be a wise consumer when seeking medical care for the new dog/puppy. Five Friends Animal Rescue can provide you with a list of low cost veterinary clinics, but you will be responsible for all medical care.
Please initial
I realize that Five Friends Animal Rescue makes every effort to adopt only healthy dogs/puppies, but CANNOT guarantee health. I understand that the dog or puppy I have adopted has been vet-checked but may have been exposed to illnesses and stressors after the vet visit and before adoption.
Please initial
Five Friends Animal Rescue has all dogs/puppies sterilized, heartworm tested, and vaccinated. No other claims are made about the dog/puppy. The donation to Fived Friends Animal Rescue is NON-REFUNDABLE and will be used to assist us in other dog/puppy rescue efforts. If Five Friends Animal Rescue feels that the dog/puppy's new home is unsuitable, we reserve the right to refuse the adoption or reclaim the dog/puppy.
Please initial
If your new dog/puppy does not get along with existing pets or members of your family right away, please give him/her time to get comfortable. Under this contractual agreement you are promising a minimum of 30 days to allow the dog/puppy to get used to the new home, sounds, smells, other pets, and family members. Change is scary for dogs/puppies and change takes time.
Please initial
If, after 30 days, you feel that the dog/puppy is not a good fit for your family, then Five Friends Animal Rescue will take him/her back. You may be required to get the dog/puppy up to date on vaccines and tests. You may also have to be patient and wait until another foster home is available, as we may move new dogs/puppies immediately into the foster home where your dog/puppy came from in order to rescue others.
Please initial
We only have so much space and demand is huge, however, Five Friends Animal Rescue will try our hardest to find a foster as soon as possible. Please return ALL medical records to us when surrendering the dog/puppy.
Please initial
I agree to MAINTAIN HEARTWORM PREVENTION for this dog/puppy.
Please initial
I understand that to fail to prevent heartworm disease is a violation of this contract and agree if the dog is ever returned with a positive heartworm test, I will be financially responsible for the future care of this dog/puppy while in the care of the rescue.
Please initial
I agree the dog/puppy will be KEPT INDOORS ONLY. I understand to not do so is a violation of this contract.
Please initial
I agree to be legally and FINANCIALLY responsible for this dog/puppy.
Please initial
I have been given a copy of Five Friends Animal Rescue's return policy and have read and understand it.
Please initial
I agree that if I can no longer keep this dog/puppy for any reason, I will return him/her to Five Friends Animal Rescue following the return policy.
Please initial
I agree that if I void this contract in any way, any and all adoption contracts entered into with the rescue are also voided and those pets must be surrendered upon request.
Please initial
I agree to reimburse the rescue for all future fees spent on this dog/puppy if I violate the terms and conditions of this contract.
Please initial
I agree to notify the rescue immediately if this dog/puppy is lost, or accidentally gets loose.
Please initial
I certify that all the information in this application is true and correct. I understand that false information and failure to complete the application in full may void this application. I agree to completely abide by the terms and conditions in this Adoption Agreement. I have read this application and understand that there are no promises or guarantees outside of what is expressly included in this form.
Please initial
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