Adoption Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
In what type of housing do you reside? Do you rent or own this property?
Landlords name if you rent:
First Name
Last Name
Landlords phone number if you rent:
Please enter a valid phone number.
Do you plan on moving in the next 12 months? If yes, what do you plan to do with the animal?
Why do you want this pet?
Is this pet a gift?
Yes
No
If it is a gift, who will be the recipient?
Have you previously owned a pet?
Yes
No
List ALL animals you have had in the last 10 years. Name? Breed? Spayed/Neutered? Vaccinated ? Do you still own any?
List all veterinarians you have taken your pets to in the last 10 years , as well as the veterinarian you plan on using for this pet.
Veterinarian
Phone Number
Do you authorize Pawsitively Posh Pet Rescue (PPPR) and its representatives to contact your veterinarian and obtain any and all veterinary records, medical history, treatment plans, vaccination records, and other relevant information regarding your pet(s), and do you release your veterinarian to provide this information to PPPR upon request?
Yes
No
Do you have an emergency veterinarian?
Yes
No
Are there any children in the house?
Yes
No
If yes, please list their ages:
In general, what type of discipline/corrections do you use with a pet?
Will you be using a crate as part of the training?
Yes
No
Do you have a fenced in yard?
Yes
No
If yes, what type and how high?
What percentage of time will this pet spend outdoors?
When this pet is outside, how will it be kept?
Fence
Chain
Line
Kennel
Dog house
In general, how many hours, per day, will this pet be left completely alone?
Where will this pet be kept while you are gone from home during the day? Crate, yard, bedroom?
Where will this pet be kept when you are out of town?
Are you willing to provide this pet with monthly heartworm prevention medicine, at your own expense?
Yes
No
Are you willing to provide this pet with yearly vaccinations, at your own expense?
Yes
No
Who will be financially responsible for the medical cost of this pet(s)?
List ANY characteristics of an animal that would NOT fit with your family or lifestyle:
Please list TWO personal references
First Name
Last Name
Please list TWO personal references
First Name
Last Name
1st reference phone number:
Please enter a valid phone number.
2nd reference phone number:
Please enter a valid phone number.
Please include any information you would like for us to consider when reviewing your adoption application for approval:
Which pet(s) are you considering?
There is a non-refundable application fee of $25 for this application. How will you pay?
Cash
Venmo : @robinmorrison031
Submit
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