Dog Adoption Application Form

Dog Adoption Application Form

This questionnaire is designed to help Annie's Ruff House and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form before adoption. Annie's Ruff House reserves the right to deny any adoption based on answers to this questionnaire and/or interviews before adoptions.
Name of Pet You Wish to Adopt*
Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Your age: *
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Do you own any pets?*

YesNo
Pet Name(s)*
Pet Breed(s)*
Pet's disposition and behavior towards other dogs?*
Veterinarian Name

First NameLast Name
Veterinarian Phone Number
Please enter a valid phone number.
Do you own or rent your home?*

OwnRent
Please provide your landlord's information here:*
Do you have a yard?*

YesNo
Is it fenced? please describe
What is your landlord's pet policy?*
Are there children in the home? (If yes, please list ages)*
How many hours per day would the pet be alone?*
Will you crate your pet?*
If you have to leave town, emergently or planned, where would your pet stay?*
How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Are you willing to work through your new pet's issues, if any?*

YesNo
What circumstances would lead you to give up your new dog?*
3 Personal References
- By clicking the submit button, I agree to go through the adoption process, will undergo a meet and greet with the dog, and brief interview.
- By clicking the submit button, I understand my references will be checked, including veterinary and personal.
- By clicking the submit button, I agree to indemnify and hold harmless the Annie's Ruff House against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet once adoption has been completed.
- By clicking the submit button, I verify all of the above information is true and accurate.
I agree to pay the adoption fee of $125 (pre-discounts) at Annie's Ruff House.*

YesNo
Date*

MonthDayYear
Date
Signature *

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