Adoption Application
Compassion Farm is a licensed 501C3 that saves dogs in Miami and Redlands. Thank you for your interest in saving a good dog that deserves a forever home.
Date
-
Month
-
Day
Year
Date
Your name
First Name
Last Name
Name of cat or dog you are requesting to adopt
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long at this address?
Occupation
Your cell phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Tell us about your home
I live in an apartment
I live in a townhouse
I live in a single family home
Other
Do you own or rent your home
I own my home
I rent my home
If rent, landlords name and phone
If you answered "Other", please explain
Do you need to obtain permission with a landlord or condo board or HOA/POA to have a pet, is so what is involved?
Drivers license and state
Upload a photo of drivers license
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Click all that apply
I live in an apartment style home with a balcony that is not "screened in"
I live in an apartment style home with a balcony that is "screened in"
I live in a house with a pool that has a child fence around it
I live in a house with a pool that does not have a child fence around it
I live in a house with a fenced in back yard
I live in a house that does not have a fenced in backyard
How many adults are there in your household?
How many children? (ages)
Do you have children visiting?
Is anyone in your household allegic to pets
Please Select
Yes
No
Describe your household
Active
Noisy
Quiet
Tell us about other animals in your house hold
Rows
How many
Ages
Were they adopted
Are they Trained
Are they Dog Friendly
What is their breed and if they are not dogs or cats (i.e. "Other") what is their species
Are they Spayed or Neutered
Dogs
Cats
Other
Other
Is everyone in your household in agreement to adopt this pet?
Please Select
Yes
No
It's just me
If you do not have any pets now but have had in the past what happend to them?
Do you plan to keep this pet inside or outside
Inside
Outside
Both
Does anyone in your household work from home?
Are you pets up to date on vaccines?
Yes
No
Are they on monthly flea/tick and heartworm preventative?
Yes
No
Other
Where will this pet stay during the day?
Do you agree to a site visit, should we request one?
Yes
No
Have you ever surrendered a pet?
Yes
No
If you surrendered a pet, what were the circumstances?
What do you plan to feed this pet and what do you plan to use for flea and tick prevention (we can suggest some options if you would like..just ask)
Do you have a regular veterinarian?
Yes
No
Name of veteranarian
Veterinarian's phone
Where will the dog spend the day? (explain)
Where will the dog spend the night (explain)
Number of hours this pet will spend alone on average?
Who will have primary responsibility for taking care of this pet's daily care?
Who will have financial responsibility for this pet?
What will you feed this pet daily?
What kind of behavior do you find unacceptable?
Do you understand that you will be sharing your life with a dog for 14-18 years, who is totally dependent on you for food, shelter and veterinary care?
Yes
No
Are you willing to make this long term committment?
Yes
No
Reference #1 - Name, address, phone, relationship
Reference #2: Name, Address, Phone, Relationship
Reference #3 Name, address phone, relationship
I agree that upon adopting a pet, I will agree and abide by the adoption Contract/Certification.
I certify all the information I have provided above is true and accurate.
Submit
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