CP Rescue: Dog Adoption Application

Canine Pawsabilities

Dog Adoption Application
Submitting this application does not mean you are commiting to a dog, nor does it guarantee you will get that dog.. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle.

After completing your application truthfully, please email (caninepawsabilitiessc@gmail.com) photos of your home and yard- everywhere the dog/puppy will have access. Why are we asking for this? Most adopters are from out of the area and we cannot always get to your location for a "home check". We do "Virtual homechecks" as well as photos. If this is something you are uncomfortable with providing, we cannot move forward in our application process.

A successful adoption depends on selecting the right cat for your household and a good understanding of the dogs needs and care requirements. Please help us with this process by answering the following questions fully & completely. THANK YOU!
Name of the dog you want to adopt*
Adopter's Name*
First & Last Name
Co-Adopter's Name
First & Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Adopter's E-mail*
Co-Adopter's E-mail*
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
Do you currently have any pets?*

YesNo
If you currently have pets, please list them below.
Are your current pets altered?

YesNoWill be within the next 30 days, appointment has been scheduled. (We will call your vet to verify this.)
If your current pets are not altered, please explain why below.
Vet reference (please call your vet and give permission to release information to us) please list vet, clinic name and phone number*
Vet name, address & phone number
Two Personal References please list full name and phone number*
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
When will you be ready to adopt this dog?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Are you in contact with any other rescues or shelters about a specific dog?*

Yes, application is pendingYes, just an email inquiry, no app yetNo, but I am looking at several dogs onlineNo, I am only interested in this particular dog
Are you going to meet another dog?*

YesNo
If so, when?
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNo
Does anyone in your home smoke?*

YesNo
Are you familiar with dog regulations in your area?*

YesNo
If you answered no to the question above, please contact your town/county/condo assoc and ask them what the regulations are.
If yes, please describe local dog regulations and restrictions:
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Renters, have you contacted your landlord to find out if there's any restrictions regarding dog ownership?

YesNoNot yet, but I willIt's written in our lease
If you rent, you must show us a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have dogs and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have a dog there and show any restrictions.
Approximate square footage of your home*

Less than 800 square feet800-1,000 square feet1,000-1,500 square feet1,500-2,000 square feetOver 2,000 square feet
Do you have a yard?*

No Yard (apartment/condo/townhome)Yard that is fencedYard that is not fenced
If your yard is fenced please tell us what type of fence is installed,

Electric/underground fencing3" wooden fence4" wooden fence5" wooden fence6" or higher wooden fence3" chainlink fence4" chainlink fence5" or higher chainlink fenceif other material please describe belowOther
Approximate dimensions of your lot:*
Annual Household Income*

Under $20,000$20,000-$30,000$30,001-$50,000$50,001-$70,000$70,001 or higher
Do you work outside the home?*

YesNoOne applicant is home/works from homeWe work different shifts
If you both work outside the home, how many hours per day are you away?
How many hours per day will this dog be alone? Please explain.*
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a dog added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this dog or think "once they meet the dog, they will want one" or "I'm getting this dog as a surprise birthday present for them." In those scenarios, you are welcome to email us to discuss the dog, but we would like all adults in the home to be involved in that email discussion.
Based on the description in the dogs bio, do you feel pretty confident that you will be likely to adopt this dog upon meeting it?*

YesNoNot sure
Upon meeting the dog, what would give you cause to not want to adopt it? Please explain.*
Fantasy question: What would your dream dog be like? (If this dog is not a fit, we may be able to recommend another based on what you say here.)*
How much do you feel you can reasonably afford and would be willing to spend on your dog per year (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)? *
What activity/energy level do you prefer?*

Wild and crazy is coolMedium energy, plays a bit then hangs out with youLow energy, a total couch potatoOther
Please check all that apply. I want to adopt this dog...*

As a family petTo breed with my dogTo train/use as a therapy dogTo interact with lots of friends/familyAs a gift for a friend, partner, or family memberAs a companion for my cats(s)As a companion for my dog(s)As a companion for my child/childrenfor a jogging/hiking partnerto train/use for hunting
Please check all that apply. My adopted dog will...

Be kept outside most of the timeBe kept indoors most of the timeBe left outside during the work day while we are awayBe kept inside while we are awayBe crated when we are not homeHave free reign of the house when we are not homeTake frequent car rides with usBe mostly interacting with adultsBe interacting frequently with children under 8Be interacting frequently with older childrenMust be potty trained trained prior to adoptionWill be potty trained trained by usBe trained by us without the advice of a trainerHave private sessions with a trainer as neededBe taking frequent car rides/trips with usBe boarded when we go on vacationStay with family when we go on vacationBe given away to someone else if we feel it's not a good match for usBe turned in to a shelter if we can't keep itBe free roaming on the farm (unfenced)Be attending formal group obedience classes with usBe going camping with usBe going on boat trips with usWill be walked more than one mile a day every dayOther
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog?*

Urinating in areas of the homeChewing/destructionJumpingCounter surfingObedience trainingFear of menFear of womenFear of childrenGrowlingRough play with my cat or dogHigh activity levelFood/toy aggression/not willing to share with other petsFood/toy aggression with peopleWhining/cryingBlindnessLimited SightDeafnessSeparation AnxietyDiabetesSpecial DietLong Term MedicationIncontinence / Leaking UrineGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsCan't climb stairs due to age/arthritis/health issuesHeart conditionSkin allergiesFood allergiesTrimming nailsYeast on coat or in earsEar mitesFleasTicksAnnual heartworm/ worm and parasite testing my veterinarian recommendsI will do whatever it takes to help this dog adjust and work with a trainer to help resolve any training needs.Providing yearly Rabies/3 year Rabies to my dog through a veterinarianProviding yearly health exams and any tests a veterinarian recommends for my dogProviding yearly vaccine booster my veterinarian recommendsProviding monthly heartworm and flea and tick prevention
What would cause you to return a dog?*
How do you plan to integrate this dog into your family?*
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
What would you do if you discovered after adoption (at any time during the life of the dog) if your vet diagnosed an expensive health condition?*
Do you plan to get pet health insurance?*

YesNoI wasn't aware this was available. I will look into it.
What brand of dog food do you plan to feed?*
Grooming (please check all that apply)*

We use a professional groomerWe trim our dogs nails ourselves at homeWe bathe our dogs at home once a weekWe bathe our dogs at home once a monthWe bathe our dogs at home once every few months or whenever their coat feels dirtyWe bathe our dog twice a yearWe don't bathe our dogWe check ears weekly for infection/yeast/mitesWe check coat daily for ticks in spring/summer/fallWe clean teeth using home methodsWe take our dogs to the vet for dentals whenever the vet recommends this is needed
How long have you been looking for a dog?*
Do you plan to update the rescue yearly after adopting?*

YesNo
If you have listed “aggression” as something you do not want to experience with a adoption please explain your definition of aggression*
Additional reference (if desired) or information you would like to add to your application
I understand that completing this application does not guarantee I will be allowed to adopt a dog, and that the application is a tool to help Canine Pawsabilities Rescue determine if this cat and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Canine Pawsabilities Rescue to contact my vet for a reference and also agree to allowing a home visit prior to adopting this cat. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption.

I understand that all dogs adopted from Canine apawsability Rescue will be spayed/neutered, heartworm tested (one year and older), microchipped, wormed, flea and tick prevention given monthly as well as heartworm monthly prevention and vaccinated prior to adoption.
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
Applicant's Signature*
Co-Applicant's Signature
Signature date*
Feel free to email us with any questions:

Contact-Caninepawabilitiessc@gmail.com

Renters: Please send a copy of the pet section of your lease or a landlord pet permission letter to the email address above.

Canine Pawsabilities Rescue reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.
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Canine Pawsabilities