Form
Date
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Month
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Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of animal you are applying for
Do you own your home or rent your home? If you rent, please provide the landlords information and phone. How long have you lived at your current address?
How many people live in your house? Number of children in the house and ages. Are you getting this pet for your kids?
Are you a college student or in the military?
Total number of people in the house: Are you married or single?
Do all household members share your decision to adopt a pet? Is anyone in your family allergic to pets?
How long have you been thinking about getting a pet?
Why have you chosen this particular pet to adopt?
Have you considered the financial costs of having a pet?
Approximately how much do you think you will spend monthly on this pet?
How many times do you think you might move in the next 5 to 10 years?
What would you do if you had to move somewhere that did not allow pets?
Are you employed, retired or on social security? What is your source of income? Where do you work?
Can you realistically commit to this dog for 10 to 15 years? Will you lose interest?
Number of hours that you work per week
How many hours will this pet be home alone on an average week day?
Will you have time to exercise this pet and where will the pet be when you are not at home?
What will you do if the dog has an accident in the house?
Have you seriously thought about the time and effort it will take to add a new member to your household and who will be the primary caretaker of this pet?
What best describes your current lifestyle: Busy, not busy or very busy
Will this dog be an indoor or outdoor dog? Do you have a dog house on the property?
Is your yard fenced in? if so what kind of fence?
If your yard is not fenced, how will you make sure the pet is safe and under control when outside?
Where will the dog stay when no one is at home?
Are you familiar with housetraining techniques? How long do you think it will take to housetrain a dog? What technique will you use?
Will you use a crate? If you plan on crate training, what is the longest time on an average day that the dog will be crated?
Where will the dog sleep at night? Are they allowed on the furniture?
List any reasons that you would rehome a dog? ( to big, unable to house train, sheds, to active, barks to much, shy, doesn't like other dogs or kids or cats, health reasons, dog aggressive)
Have you ever used doggy daycare, dog trainers or puppy classes?
Have you ever adopted from a shelter or rescue group? Which one?
List all current and past pets in the last 10 years ( alive or deceased) How long did you have them and age and breed. Were they spayed and what happened to them?
Are you aware that there may be special problems associated with dogs that may have been neglected or abused and are you prepared to deal with these problems and maintain your commitment to this dog?
Are you familiar with puppy mill dogs?
Vets name and phone number
Does your vet have records for all of your past and present pets?
Are all of the pets you have now, current on their rabies vaccination and other shots?
When was the last time you were at your vet?
Is it ok if we contact your vet for a reference?
Name and number of a personal reference
How did you hear about us?
Signature
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