Dog / Puppy Adoption Application

Adoption Application

Chaos To The Rescue
Thank you for considering adoption through Chaos To The Rescue! Dogs and puppies are fun, loving, and playful, but they also require a lot of care and attention. Before starting this application, please ensure you are fully committed to their well-being. All rescue dogs need some training, and if you're not willing to invest in this, we ask that you not submit an application. While we strive to rehome well-behaved dogs, the rehoming process can be stressful, especially for those recovering from abandonment or neglect. It may take anywhere from a few days to several weeks for a dog to adjust to its new home.

If you're ready to adopt, please complete this adoption form as thoroughly as possible. After submission, a team member will follow up with you soon.

(Note: We reserve the right to refuse any adoption that we feel will not suit the dog’s/puppy’s requirements.)

To see our pets for adoption, CLICK HERE.
Name of dog you are interested in:
Your Name

First NameLast Name
Email
A confirmation will be sent to this email.
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
PET SECURITY & SAFETY
Select the option that best describes your current home or primary residence:

HouseApartmentCondoBoatDormitoryOther
If Other type of residence, please explain:
Select the option that best describes your residency:

OwnerRent/ TenantOther
If you rent or live in a community with an HOA, are you allowed to have a dog? Check for any restrictions on size, breed, or number of pets. Before adopting, be prepared to provide a copy of your rental or HOA policy or written confirmation that you are permitted to have a dog.
Do you have permission from your landlord to have a dog/puppy live on the property?

YesNoUnsure
Landlord's Name:
Landlord's Phone #:
Please enter a valid phone number.
How many members are in your household (including yourself)?
Are there any babies, toddlers or young children that live in your household?

YesNo
What are their ages?
Does every member of your household agree to the adoption of this pet?

YesNo
Is any member of your household allergic to pets or animials?

YesNo
If allergic, please explain:
Could you provide one or two references who can vouch for your pet ownership? This could be a friend, family member, or someone who knows you and your pets well.
PET SECURITY & SAFETY
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?

YesNo
Where will your dog sleep (be specific)?
Do you have a dog door at your residence?

YesNo, but I plan on installing oneNo, and I do not plan on installing one
Do you have a private fenced yard?

YesNo
What percentage of the time will the dog be in the yard?
Do you share your yard with anyone else?

YesNo
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?

YesNoUnsure
Do you have a swimming pool on your property?

YesNo
Is the pool secure and gated?

YesNo
What is your primary reason for wanting a rescue dog?
PET SECURITY & SAFETY
Please choose the option that best describes your employment status:

Employed Full-timeEmployed Part-timeUnemployed/ In-between JobsRetired
When you are at work, where will the dog be?
Will anyone in your household be home when you are at work?

Yes, alwaysYes, sometimesNo
At the moment, is anyone at your home during the day?

Yes, alwaysYes, sometimesNo
When you go on vacation or a trip, who will care for your dog? (select all that apply)

Dog sitter home with DogSomeone to visit/feed, but doesn't stayFriend or Relative's HomeBoarding KennelVeterinarianOther
If Other type of care, please explain:
Do you currently have any other pets/animals living in your household?

YesNo
What kind of pets/animals?

Dog(s)Cat(s)Bird(s)Reptile(s)LivestockOther
If Other type of animal, please explain:
Please describe the other dog(s) that live in your household?
(i.e. breed, age, sex, etc.)
Is the other dog(s) in your household spayed or neutered?

YesNo
Please explain why the other dog(s) are not spayed or neutered:
Have you ever had a dog before?

YesNo
How many years of experience do you have as a dog owner?
Have you ever had a dog (or another beloved pet) pass away before?

YesNo
What happened to him/her?
Under what circumstances would you consider giving up/ surrendering your dog (check all that apply)?

Behavior problemsBig vet billsJob change/lossMovingDog loses control of bladder/ bowelsDog develops chronic illness/disabilityDog does not meet my expectationsDog nips at strangersDog nips/bites kidsDivorce/SeparationOld AgeNone of the aboveOther
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?

YesNo
If you are not willing to consult with a trainer, please explain why not?
PET SECURITY & SAFETY
Have you ever been responsible for losing a dog (or another pet) before?

YesNo
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 vehicleCheck shelters/rescuesPut up signsPut up ads in local mediaTake flyers door to doorOther
In the past, have you ever been forced to give up your dog (or another pet) before?

YesNo
What was the surrender process?

Gave to friend or relativeFound pet a new home through outreachSurrendered pet to local shelterSurrendered pet to animal rescue/ adoption groupOther
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?

YesNo
Are you prepared to spend the money for proper care of your dog, if needed?

Yes, whatever the costsYes, but within reason or limitsNo
If you have cost limitations, please explain:
Do you currently have a trusted veterinarian?

YesNo
Name and Phone of your veterinarian:
PET SECURITY & SAFETY
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?

YesNo
Do you still use those same training methods?

YesNo
Do you think it is necessary for your dog to wear an ID tag?

Yes, all the timeYes, occasionallyNo
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)?

YesNo
Are you prepared to make a commitment to provide love and care for this new pet (up to 15+ years, if time permits)?

YesNo
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 the appropriate adoption donation fee ($450). I understand that Chaos To The Rescue is a non-profit organization whose main goal is to save dogs from being euthanized. This fee covers all vaccines, spay/neuter procedures, transport, and any necessary medical care.I agree to return the dog to Chaos To The Rescue if it does not work out in my home.I understand that animal behavior found in one home is not necessarily the same behavior it may exhibit in a different home; and I understand Chaos To The Rescue cannot and does not guarantee a dog’s behavior based on past history.I understand that any misrepresentation of the above information authorizes Chaos To The Rescue to deny my application, and/or reclaim the pet that is in my home. I acknowledge that Chaos To The Rescue cannot guarantee any animals against parasites, diseases or destructive behavior. If I adopt a dog from Chaos To The Rescue I will not hold Chaos To The Rescue responsible, nor seek any compensation for damages, medical fees or other liabilities incurred by the pet I adopt.
Initials here:
Drivers License or Identification Card

We understand that requesting these details may raise concerns, but it is necessary to ensure the safety and well-being of dogs by helping us identify and prevent any involvement in dog fighting rings. We are committed to protecting the privacy and security of all users.
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