PAWHS ADOPTION FORM
226 Vigilante Drive; Deer Lodge, Montana
Name of Applicant
Name of dog/cat/other you are interested in adopting?
Email
Address/City/State/Zip
Phone Number
Do you live in an
House
Apartment
Mobile Home
Do you
Own
Rent
If you rent, name of landlord and contact phone number.
How long have you lived at your current residence?
Prior address if less than 6 months at current residence.
How much of the time will the dog be outdoors?
How much of the time will the dog be indoors?
About what percentage of the time will the dog be left alone and where will it be left alone?
What areas of the house will the dog be allowed in?
Where will the dog sleep at night?
Do you have a fenced yard? If so, what type of fence and how tall? Are the gates closed consistently? Please go into detail.
Why do you want a PAWHS dog? Please check all that apply.
House Pet
Family Companion
Companion for other pet
Working dog
Have you adopted from PAWHS before?
Yes
No
If yes, shelter name of pet and approximate date of adoption?
Do you still have the pet? If no, explain why you no longer have the pet.
What other pets do you have in the home?
If there are other pets in the home, are they spayed or neutered or intact?
What pets have you had in the past?
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What happened to the pets you no longer have?
What would happen to the PAWHS dog if you moved locally?
What would happen to PAWHS dog if you moved out of the country?
Do you have a regular Veterinarian?
Yes
No
If so, state Veterinarian/Vet Clinic’s name and phone number
Does anyone in your household have allergies to pets?
No
Yes
Have you ever had to remove a pet from your home due to allergies? If yes, please describe.
How would you train your dog? Choose all that apply.
Obedience school
Firm verbal commands
Positive reinforcement
Other tools like clicker and training collar
Will you be able to live with dog hair on your furniture, stains on your carpet, a warm body on your bed and an animal that may be destructive at times?
Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, exercise and shelter for your dog?
What are you estimating the cost for your new dog per year?
Are you able to make a commitment to care for this dog for its entire life span, which could be as long as 10-20 years?
Under what circumstances would you not be able to keep this dog?
Name and phone number of a family member we can contact if we are unable to get hold of you.
Date
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Month
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Day
Year
Date
Signature
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