Clone of CHEW ANIMAL CLINIC - ADOPTION APPLICATION

The adoption fee is $750 and includes the following services, all provided at CHEW:

Doctor exams
(2) DHPP vaccinations (1 completed)
(2) Leptospirosis vaccinations
Bordetella vaccination (completed)
Rabies vaccination
Microchip implantation (completed)
(3) rounds of deworming
Spay/neuter surgery (completed)

Please note: These services must be completed at CHEW to be covered by the adoption fee. Any services performed elsewhere will not be reimbursed or included.

The remaining portion of the adoption fee will be directed to our Compassion Fund, which helps provide care for animals in need. CLICK HERE FOR MORE INFO

What puppy are you wanting to adopt?*

NAME*

First NameLast Name

ARE YOU OVER 21 YEARS OF AGE?*

YESNO

ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

HOW LONG AT THIS ADDRESS?*

Upload pictures of your back yard, including the fence line

Browse Files

DAYTIME PHONE*

Area CodePhone Number

EVENING PHONE*

Area CodePhone Number

OWN YOUR HOME?*

RENT? (if yes, you must have landlord approval)*

IS YOUR YARD FENCED?*

YESNO

Is a member of your household at home during the day?*

WHERE WILL HE SPEND THE DAY?*

WHERE WILL HE SPEND THE NIGHT?*

WHAT OTHER ANIMALS DO YOU HAVE AT HOME*

ARE THEY SPAYED OR NEUTERED?*

YESNO

IF NO, PLEASE EXPLAIN:*

IF YOU HAVE OTHER DOGS OR CATS ARE THEY CURRENT ON VACCINATIONS?*

YESNO

ARE THERE CHILDREN IN THE FAMILY?*

YESNO

IF YES, WHAT ARE THEIR AGES?*

BY TYPING MY FULL NAME BELOW, I AFFIRM THAT ALL INFORMATION ABOVE IS TRUE. *

TYPE FULL NAME HERE