ADOPTION APPLICATION
Pet you're interested in:
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Personal information (please print)
Name:
First Name
Last Name
DOB:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
How did you hear about us?
Household information
Number of Adults:
Ages (Adults):
Number of children:
Ages (Children):
Home Type
Detached Home
Condo
Apartment
Housing Status
Own
Rent
Lease
If you rent or lease, are there any pet restrictions?
Landlord Name:
First Name
Last Name
Landlord Phone:
Format: (000) 000-0000.
(we will be contacting your landlord to make sure owning a dog/cat is acceptable under your lease, we must receive positive confirmation before you can adopt)
All Current Pets: (please allow us access to your vet's records by calling ahead and letting them know we will be contacting them)
letting them know we will be contacting them)
Rows
Name
Breed
Age
Sex/altered
Weight
Heartworm UTD
Vaccines UTD
1
2
3
4
(Please list further in home pets on last page of application and list reason if not UTD on vaccines or heartworm preventative)
Veterinarian's Name and Number:
Back
Next
Yard:
Completely fenced
Partially fenced
No fence
Other
Material:
Chain link
Wood
Other
If no fence, the dog must be on a leash at all times.
How would you describe your level of experience with dogs?
Never owned a dog
Had a childhood dog
Had one or more dogs as an adult
Have experience with powerful breeds
Have experience working at boarding/training facility, dog daycare, etc.
Have experience working at a veterinarian
Have experience with on-going medical issues of own dog
Have experience with behavioral issues
Am a professional dog trainer
What breeds have you had personal experience with:
Are you agreeable to crating the dog when dog is unattended:
How many hours will the dog be home alone:
Where will the dog be when alone:
If something happens to you and you are unable to care for the dog, what is your plan:
What situations do you feel unprepared for or unwilling to deal with: (select all that apply)
Rows
Deaf/blind
Excessive barking,
Destructive chewing,
Not housetrained,
Digging
Escaping
Resource (food/toy) aggression
Shy, fearful, undersocialized
Back
Next
Size preference:
Small
Medium
Large
Giant
Breed preference:
Age preference:
Please list any additional information that we may need
Please list any additional dogs/cats in the home:
Preview PDF
Submit
Should be Empty: