Rescue Rehome Pet Adoption Application

Pet Adoption Application
Name of dog you would like to adopt:*
Adoption Applicant*

First NameLast Name
Phone Number we can reach you at*
Please enter a valid phone number.Format: (000) 000-0000.
Text messages can be received at this number
Email Address*
example@example.com
Street Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Government ID/Drivers License

Cancelof
Date of Birth*

MonthDayYear
Date
Occupation*
Facebook Profile Name*
If you do not have a Facebook, type "N/A"
Instagram Profile Name*
If you do not have an Instagram, type "N/A"
YesNo

Co-Adopter Information

Please provide information for the co-adopter.
Co-Adopter*

First NameLast Name
Co-Adopter Email Address
example@example.com
Co-Adopter Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Text messages can be received at this number
YesNo
Co-Adopter Street Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Government ID/Drivers License

Cancelof
Co-Adopter Date of Birth*

MonthDayYear
Date
Co-Adopter Occupation*
Facebook Profile Name
Instagram Profile Name

Veterinarian Verification
Please list a veterinarian or veterinary clinic that you have worked with in the past or currently use for your pets. This may be your current veterinarian or a clinic you have used previously.

We use this information to verify that you have established veterinary care for your pets, either currently or in the past. Demonstrated veterinary care is an important part of our adoption and screening process and helps us ensure that our dogs will continue to receive proper medical care in their new homes.
Veterinary Office or Hospital Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Email Required for Vet verification, please obtain correct email before submitting.
Veterinarian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Name that YOUR Veterinary Account is Under:
(Usually your own name but may be a spouse or family member's name)
Phone number that is on YOUR Veterinary Account:
I hereby authorize the veterinary clinic to share information related to my pets' veterinary records and my account details with Rescue Rehome for the purpose of assessing my pet adoption application.*

Personal References

Please provide two personal references (not relatives).
Reference 1*

First NameLast Name
Reference 1 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Email*
Email Required for References, please obtain correct email before submitting.
What is your relationship to this reference?*
How long have you known this reference?*

Personal References

Please provide two personal references (not relatives).
Reference 2*

First NameLast Name
Reference 2 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Email*
Email Required for References, please obtain correct email before submitting.
What is your relationship to this reference?*
How long have you known this reference?*

Virtual Home Tour

Show us around your place!
As part of our adoption process, we kindly request that you provide us with a virtual home tour. This is an important step that allows us to ensure the safety and suitability of your home for a new pet.

Here’s what we would like you to include in your video:

- A walk-through of the main living areas of your home.
- A view of your backyard and any other outdoor spaces where your pet might spend time.
- Please highlight areas where the pet will eat, sleep, and play.

How to Submit Your Video:

- You can easily record the video using your smartphone.
- Ensure that the video is clear with good lighting for visibility.
- The video doesn’t need to be professional; we are just looking to get a sense of the space.

Once your video is ready, please upload it here below!
Link to your home tour video (YouTube, Google Drive, etc.)
Please upload your video to a service like YouTube (unlisted), Google Drive, or Dropbox and paste the shareable link here. If you cannot do this, a home tour video will be requested at another time before approval of your application.

Final Touches
We do our best to make thoughtful, lasting matches between our dogs and adopters. If there’s anything else you’d like to share about your household or what you’re looking for in a new companion, we’d love to hear it!
Yes, we are going to meet another dog.Yes, we have an application pending.Yes, just an email inquiry, we have not submitted an application.No, but I am looking at several dogs online.No, I am only interested in this particular dog.
How soon will you ready to bring your newly adopted pup home? Do you have a timeline or scheduled trips to plan around?*

Pet Adoption Application