Our House of Hope Adoption Application

Our House of Hope Adoption Application

This is a comprehensive adoption application which may seem formal, but it is intended to ensure that the right dog is being placed with you. An improper placement, or one based on inadequate information, can end tragically for the dog and the adoptive family.Every question must be answered in order for this application to be complete and for you to be considered. All information furnished here will be kept confidential and will only be available for use by Our House of Hope. All of our dogs will be spayed or neutered prior to adoption
PERSONAL INFORMATION
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Age*
Email*
example@example.com
Occupation and Position Title*
Employer Name and Work Schedule*
YOUR FAMILY
Who is this pet for?*

SelfChildEntire FamilySpouseParentOther
Choose One:*
If Single:*
Do you plan on adding more members to your household in the future?*
How many smokers live in your home?*
Do any members of your family have any ongoing medical conditions (including allergies) that might interfere with ownership of a new dog?*

YesNo
If yes, please explain:
List all other members of the household where the pet will live*
YOUR HOME
Choose one:*

I ownI rent
It is a...*

HouseCondoApartmentTownhouseOther
If renting, does your landlord and/or tenant’s association permit pets? A copy of your lease is required if you are renting*

YesNoN/A
Renters: Please supply the following for verification:
How long have you lived at this address?*
Do you have a fence attached to this address*

YesNoN/A
If yes, please describe your fence:*
If there is no fence, how do you plan for the dog to relieve itself?
Do you have a pool?

Yes, however it is fenced separatelyYes, it is enclosed in the yard where the pet can access to itNo
Do you plan to move in the future?*

YesNoNot Sure
If yes, when and where to?
PET HISTORY
Have you ever tried to adopt from Our House of Hope in the past?*

YesNo
If yes, what happened?
Have you ever owned other pets?*

YesNo
If yes, please give a brief history and state what happened to it (them):
Please list all other pets currently residing in your household*
If you have other pets, describe & explain their behavior towards people and other animals:
Are there any dogs belonging to family or friends that might be aggressive towards your dog?*

YesNoN/A
If yes, please explain:
With any past or present pets, have you had any behavioral problems?*

YesNoN/A
If yes, please explain:
Are you prepared to spend the time necessary to accustom other animals to the new dog?*

YesNoN/A
Can you isolate the other animals if they cannot get along?*

YesNoN/A
YOUR LIFESTYLE
Who will have primary responsibility for this pets’s feeding, grooming, veterinary care, etc.?*
Does everyone in your family want a new pet?*

YesNo
If no, why not and what are their concerns?
How many hours a day will this pet be without people around? (be realistic)*
If you work and are home for lunch, what is your actual time at home at lunchtime?*
Where will your pet be kept when no people are home?*
Where will your pet sleep at night?*
What will you feed your pet?*
If you are away for a few days or go on vacation, who will take care of your pet?*
Do you have children under 7 that visit your home?*

YesNo
If yes, how many are there and how often do they visit?
Are you willing to attend classes to train this dog?

YesNoN/A
Do you intend to crate train the dog?

YesNoN/A
What action by the dog would lead you to discipline it (e.g. soiling, barking, biting, etc.) and how do you discipline?*
can type n/a for exotics
ADOPTION PREFERENCES
What sex do you prefer?*
What age do you prefer?*

Juvenile / PuppySeniorAdultNo preference
Do you have a specific pet in mind?*

YesNo
If yes, which animal(s)?
Will you accept a dog that barks, needs housebreaking, or other obedience help?*

YesN/ANoMaybe with the following conditions:
What are your conditions if you answered maybe for the question above?
What other pets, if any, have you been considering?
HEALTH STATUS OF DOGS
All of our dogs have been examined by a veterinarian and have been spayed or neutered.

Dogs available for adoption have been provided with proper health care and adoptive families will be informed of any conditions that are made aware of to Our House of Hope.
Will you accept and treat with proper veterinary care a pet with medical problems for as long as necessary?*

YesNo
We expect our dogs to have an annual physical exam with immunizations, regular rabies vaccinations, and to be on monthly heartworm preventative medication.

We also expect their teeth to be cleaned as needed because periodontal disease is the #1 killer of small dogs. Grooming is also required as needed.
Do you understand that there are routine yearly costs involved for the pet and have you budgeted for these?*

YesNo
Have you budgeted for emergency veterinary care?*

YesNo
If no, please explain:
Will you have difficulty financially if you have major expenses for your pet?*

YesNo
REFERENCES

All references will be checked. You may be asked to provide additional references
Please provide the name and phone number of TWO non-relative character references we may contact.*
Veterinary Reference
If you don't have a veterinary reference, please explain why:
Please provide the name, address, and phone of your pet’s groomer. If not applicable explain why:*
VISITS

Our House of Hope requires that prospective adoptive parents visit the pet prior to the actual adoption.
Would you be willing to allow an Our House of Hope representative to visit your home prior to and/or after adoption?*

YesNo
If no, please explain:
Final Confirmation
Should be Empty:

Our House of Hope Adoption Application

PERSONAL INFORMATION

YOUR FAMILY

YOUR HOME

PET HISTORY

YOUR LIFESTYLE

ADOPTION PREFERENCES

HEALTH STATUS OF DOGS

All of our dogs have been examined by a veterinarian and have been spayed or neutered.

We expect our dogs to have an annual physical exam with immunizations, regular rabies vaccinations, and to be on monthly heartworm preventative medication.

REFERENCES

VISITS

Final Confirmation