Dog & Puppy Adoption Form

Date*

Date

Full Name*

First NameLast Name

E-mail*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your occupation?

Which dog or puppy are you interested in?*

CompanionCompanion for petGuard Dog

YesNo

If you rent, are there any restrictions regarding size, type, or how many animals you can have? (type N/A if not applicable)*

Type of Dwelling:*

May we contact your landlord? If so, can we have their name and phone number: (if you own your home, please put self)*

How long have you lived at this address?*

Please list the names and ages of everyone in your home.*

Please provide the name, address, and phone number of your veterinarian so that we may call for a reference:*

Are all humans in your home aware and in agreement with you adopting a dog or puppy?*

Please describe your household: Busy | Calm | Children are in and out a lot | Many people stop by:*

Are you familiar with the 3/3/3 rule?*

Will arrangements be made if you are traveling?*

What will your dog or puppy do for potty breaks and exercise?*

Who will be responsible for caring, training, exercising the dog or puppy?*

How many hours a day will the dog or puppy be alone and where will the dog or puppy be kept?*

Where will your dog or puppy spend most of his/her time?*

Do you have a fenced yard? If so, is it secure? What type of fencing is it?*

YesNo

If yes, please describe:

Over the past 5 years, how many pets have you owned? (Include current pets)*

Please list breed, age, if they're still living with you. (If not, why?)*

YesNo

If yes, please describe:

If you currently own a dog or cat, how do they react to a new dog or puppy?*

YesNoN/A

Please describe your personal knowledge of training and experience with dogs.*

YesNo

If there is anything else you think we should know, please note it here.

PLEASE READ:

To the best of my knowledge, all the information I've given is true and complete. I will comply with all rules and policies of JustCare Animal Rescue & Sanctuary. The choice to adopt a dog(s) or puppy(s) is mine.

By adopting a dog(s) or puppy(s), I release JustCare Animal Rescue & Sanctuary from any responsibility for damage, injury, or harm caused. JustCare Animal Rescue & Sanctuary, at its sole discretion, reserves the right to refuse any applicant for any reason.

In the event that you are unable to care for or keep your dog(s) or puppy(s), he/she should be returned to JustCare Animal Rescue and Sanctuary.
I will provide the animal with proper and adequate food, water, shelter, training, and affection. I will provide medical care, if needed, and as approved by the veterinarian. JustCare Animal Rescue & Sanctuary does not guarantee an animal's temperament, or behavior. JustCare Animal Rescue & Sanctuary, at its sole discretion, reserves the right to refuse any applicant for any reason.

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