Adoption Application
LADY'S LEGACY
Name of dog you are interested in:
*
Your Name
*
First Name
Last Name
Email
*
A confirmation will be sent to this email.
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
Select the option that best describes your current home or primary residence:
House
Apartment
Condo
Other
If Other type of residence, please explain:
Select the option that best describes your residency:
Owner
Rent/ Tenant
Other
If you rent, do you have permission from your landlord to have a dog/puppy live on the property?
Yes
No
Unsure
N/A
Landlord's Name:
Landlord's Phone #:
Please enter a valid phone number.
Format: (000) 000-0000.
How many members are in your household (including yourself)?
Are there any babies, toddlers or young children that live in your household?
Yes
No
What are their ages?
Does every member of your household agree to the adoption of this pet?
Yes
No
Is any member of your household allergic to pets or animials?
Yes
No
If allergic, please explain:
Please select the type of living situation you plan for this dog:
Indoor (Only)
Indoor/ Outdoor (Combo)
Outdoor (Only)
Is the dog allowed on the furniture?
Yes
No
Where will your dog sleep (be specific)?
Do you have a private fenced yard?
Yes
No
What percentage of the time will the dog be in the yard?
Please Select
0% (Indoor only)
Under 10%
10% to 50%
50% to 90%
Over 90%
100% (Outdoor Only)
Do you share your yard with anyone else?
Yes
No
Please describe the type of fencing you have surrounding your yard:
(e.g. wooden, chain-link, concrete, etc.)
How high is your fence (at its lowest point)?
If you have a gate to enter/exit your yard, how high is your gate?
Are you certain your yard and fencing are secure enough for dog?
Yes
No
Unsure
Do you have a swimming pool on your property?
Yes
No
Is the pool secure and gated?
Yes
No
Please choose the option that best describes your employment status:
Employed Full-time
Employed Part-time
Unemployed/ In-between Jobs
Retired
When you are at work, where will the dog be?
If crated, approximately for what duration?
1-3 hours
4-6 hours
7 hours +
At the moment, is anyone at your home during the day?
Yes, always
Yes, sometimes
No
When you go on vacation or a trip, who will care for your dog? (select all that apply)
Dog sitter home with Dog
Someone to visit/feed, but doesn't stay
Friend or Relative's Home
Boarding Kennel
Veterinarian
Other
If Other type of care, please explain:
Do you currently have any other pets/animals living in your household?
Yes
No
What kind of pets/animals?
Dog(s)
Cat(s)
Bird(s)
Reptile(s)
Livestock
N/A
Other
If any, what is your primary veterinary clinic?:
If Other type of animal, please explain:
Please describe the other dog(s) that live in your household?
(i.e. breed, age, sex, etc.)
Are other animals in your household spayed or neutered?
Yes
No
Please explain why the other dog(s) are not spayed or neutered:
Have you ever had a dog before?
Yes
No
How many years of experience do you have as a dog owner?
Please Select
0 - 3
4 - 7
8 - 11
12 - 15
15+
Have you ever had a dog (or another beloved pet) pass away before?
Yes
No
What happened to him/her?
Under what circumstances would you consider giving up/ surrendering your dog (check all that apply)?
Behavior problems
Big vet bills
Job change/loss
Moving
Dog loses control of bladder/ bowels
Dog develops chronic illness/disability
Dog does not meet my expectations
Dog nips at strangers
Dog nips/bites kids
Divorce/Separation
Old Age
None of the above
Other
If Other type of circumstance, please explain:
If your dog were to develop or have behavior issues (i.e., nipping, biting, barking, digging), will you be willing to consult a trainer to try to rectify the situation before giving the dog up?
Yes
No
Have you ever been responsible for losing a dog (or another pet) before?
Yes
No
How did you lose that pet?
If your dog gets out, which of the following will you do (check all that apply)?
Search the local area by foot and vehicle
Check shelters/rescues
Put up signs
Put up ads in local media
Take flyers door to door
Other
In the past, have you ever been forced to give up your dog (or another pet) before?
Yes
No
What was the surrender process?
Gave to friend or relative
Found pet a new home through outreach
Surrendered pet to local shelter
Surrendered pet to animal rescue/ adoption group
Other
If Other type of surrender, please explain:
What will you do if/when your dog gets sick or injured?
Do you know how much veterinary care typically costs?
Yes
No
Are you prepared to spend the money for proper care of your dog, if needed?
Yes
No
If you have cost limitations, please explain:
Do you currently have a trusted veterinarian?
Yes
No
Name and Phone of your veterinarian:
What will you do if/when your dog/puppy misbehaves (e.g. chews your favorite shoes or furniture)?
How will you get your dog/puppy to do what you want him or her to do?
Have you ever trained a dog/puppy in obedience class?
Yes
No
Do you still use those same training methods?
Yes
No
Do you think it is necessary for your dog to wear an ID tag?
Yes, all the time
Yes, occasionally
No
A pet requires a lot of people attention. Are you prepared to spend a lot of time with your new pet (for the rest of it’s life)?
Yes
No
Are you prepared to make a commitment to provide love and care for this new pet (up to 15+ years, if time permits)?
Yes
No
The 3-3-3 rule is essential for a smooth transition when bringing home an adopted dog. Do you agree to read the adoption guide on Lady’s Legacy’s website and follow these guidelines to help ensure a successful adjustment?”
Yes
No
By checking the following boxes, I am agreeing to the following statements:
*
All information I shared in this form is accurate and true to the best of my knowledge.
I understand that filling out this application form is NOT a guarantee of adoption.
If my application is approved, I agree to pay an appropriate adoption fee to help offset the high cost of rescuing.
Signature
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Name
Today's Date:
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Month
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Day
Year
Date
Please verify that you are not a robot or a cat.
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