Second Chance Pet Network Dog Adoption Form

*Please note you will be required to show ID with your current address on it.

*We reserve the right to deny any adoptions

FULL NAME*

First NameLast Name

ARE YOU OVER 18 YEARS OF AGE?*

YESNO

ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

HOW LONG AT THIS ADDRESS?*

EMAIL ADDRESS*

DAYTIME PHONE*

Area CodePhone Number

EVENING PHONE*

Area CodePhone Number

WHAT TYPE OF HOME DO YOU LIVE IN?*

HOUSEAPARTMENTTRAILER/MOBILE HOMEOther

DO YOU OWN, RENT, OR LIVE WITH PARENTS?*

OWNRENTLIVE WITH PARENTSOther

IF YOU RENT, DOES YOUR LANDLORD ALLOW PETS?

YESNO

NAME & NUMBER OF LANDLORD (IF APPLICABLE)

WILL YOU ALLOW A REPRESENATIVE OF SECOND CHANCE TO VISIT YOUR RESIDENCE TO DETERMINE SUITABILITY?*

YESNOOther

WILL YOU ALLOW A REPRESENATIVE OF SECOND CHANCE TO CONTACT YOUR VET?*

YESNO

WHAT IS THE NAME & PHONE # OF YOUR VETERINARIAN?*

FULL NAMES OF ALL ADULTS LIVING IN THE HOME*

DO YOU HAVE ANY CHILDREN? IF YES, WHAT AGE(S)?*

DO YOU OR ANYONE IN YOUR HOUSEHOLD HAVE ALLERGIES (PET) OR ASTHMA?*

YESNO

IS YOUR YARD FENCED?*

YESNO

HOW WILL YOUR DOG BE EXERCISED?*

WHY DO YOU WANT TO ADOPT A DOG?*

WHERE WILL HE SPEND THE NIGHT?*

IF OUTSIDE, DO YOU HAVE SHELTER AVAILABLE FOR HIM?*

YESNO

HAVE YOU OWNED PETS IN THE PAST 5 YEARS?*

YESNO

IF YES, HOW MANY AND WHAT HAPPENED TO THEM?*

WHAT ANIMALS DO YOU OWN NOW?*

ARE THEY SPAYED OR NEUTERED?*

YESNO

IF NO, PLEASE EXPLAIN:*

IF YOU OWN OTHER DOGS OR CATS ARE THEY CURRENT ON VACCINATIONS?*

YESNO

ARE YOU AWARE THAT ALL SCPN DOGS MUST BE SPAYED/NEUTERED AT THE APPROPRIATE AGE?*

YESNO

ARE YOU AWARE OF LOCAL BYLAWS AND LICENSING REQUIREMENTS?*

YESNO

ARE YOU AWARE SCPN OFFERS MICROCHIP SERVICES FOR YOUR PET?*

YESNO

ARE YOU FINANCIALLY PREPARED TO PROVIDE THE NECESSARY CARE FOR YOUR PET: INCLUDING PROPER FOOD, VACCINATIONS, PARASITE CONTROL (FLEAS, TICKS, WORMS, ETC.) ADEQUATE SHELTER, AND VETERINARY CARE FOR YEARLY CHECK-UPS AND MEDICAL EMERGENCIES?*

YESNO

DOGS CAN LIVE TO BE 15 YEARS OR OLDER. HAVE YOU CONSIDERED HOW THIS WILL AFFECT YOUR FUTURE?*

YESNO

HAVE YOU EVER PLACED A PET IN AN ANIMAL SHELTER?*

YESNO

IF YES, WHAT WAS THE REASON?*

HAVE YOU DISPOSED OF A PET IN THE LAST 10 YEARS? IF YES, WHY?*

PLEASE BE AWARE THAT A PET IS FOR LIFE AND A PART OF THE FAMILY. A PET CAN LIVE TO BE 20 OR MORE AND YOU NEED TO BE RESPONSIBLE FOR THE LIFE OF YOUR NEW PET. TAKE THESE INTO CONSIDERATION BEFORE ADOPTING:

IF YOU MOVE, YOUR PET MOVES WITH YOU!
IF YOU ACQUIRE A NEW PARTNER, MAKE SURE THAT PARTNER LIKES PETS!
ALLERGIES CAN BE DEALT WITH. ITS POSSIBLE YOU ARE ALLERGIC TO MORE THAN DANDER. YOU SHOULD GET CHECKED OUT BY A DOCTOR. KEEP ONE ROOM PET FREE (LIKE YOUR BEDROOM). MAKE SURE ALL PET PRODUCTS ARE MACHINE WASHABLE. VACCUUM REGULARLY (EVEN FURNITURE) BATHE AND BRUSH YOUR PET WEEKLY!
YOUR PET IS LIKE A CHILD. IT NEEDS LOVE, ATTENTION, TRAINING.
DOGS ARE PACK ANIMALS AND LIKE TO BE AROUND FAMILY. THEY SHOULD NOT BE LEFT ALONE OUTSIDE ALL DAY ON A CHAIN!
DOGS REQUIRE PROPER EXERCISE AND SHOULD BE WALKED DAILY.
TREAT THEM LIKE FAMILY AND YOU WILL HAVE A LOVING, LOYAL AND FAITHFUL COMPANION FOR THEIR LIFETIME.

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