Dog Adoption Application

Puppy/Dog Adoption Application
Our rescue organization is making every effort to place our foster puppies and dogs in a home that fits their needs & personalities. We appreciate your sharing the following information with us to assist in our mission.
What puppy/dog are you interested in adopting & why?*
Your name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your email*
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Names and ages of all permanent residents of your home (adults/children)*
If applicable, will your children be taught how to play gently and kindly with this animals?*
If no children, do any ever visit?*
What type of home do you live in?*

HouseApartment/CondominiumManufactured home
Do you own or rent your home?*
If you rent , please provide your landlord/renting agency's phone number*
Do you mind if we conduct a home visit prior to or after adoption?*

NoYes
Describe your yard & fencing*
Please list all pets currently living in your home along with their age/breed and if they are altered*
What other pets have you had in the last 5 years?*
Why are they currently not with you?*
Have you ever surrendered or returned a pet to a shelter?*

YesNo
Have you ever given away or sold an animal?*

YesNo
If yes to either question above, please explain
What would you consider a reason for not keeping a puppy/dog?*
Rescued animals need time to adjust to their new home. How long are you willing to give this puppy/dog to adjust?*
Puppies/dogs sometimes chew furniture, shoes, woodwork, etc., how would you manage this problem?*
Will your puppy/dog be housed?*

Inside onlyInside/outsideOutside only
Describe the dynamics in your household (busy/quiet). How many hours a day will the puppy/dog be alone?*
Does anyone in your house have pet allergies?*

NoYes
Do you use parasite prevention?*

YesNoExplain:
What kind of heartworm prevention do you use?
If you go out of town on vacation, who will care for your animal?*
If something were to happen to you, do you have a plan in place for your pets?*
What veterinarian do you use? Name/phone number*
May we contact your veterinarian?*

YesNo
Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance, savings, Care Credit)*
Do you have additional comments, questions or concerns?
By clicking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any sort of fighting, breeding or cruelty. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the group and explain your situation before taking the animal to a shelter.

I have not nor has anyone in my household ever been charged with any form of animal abuse, neglect or cruelty.

I am 18 years of age or older and have read this application in it's entirety and have answered each question honestly and to the best of my ability.
Applicant's signature*
Co-applicant's signature
Date

MonthDayYear
Thank you for taking the time to submit this form.

Please feel free to contact me (the person you are adopting from) or any of the adminis in the Adopt/Rehome network. After you click the Submit button, you will be redirected to the main page and you will receive a confirmation email.
Should be Empty:

Puppy/Dog Adoption Application

Our rescue organization is making every effort to place our foster puppies and dogs in a home that fits their needs & personalities. We appreciate your sharing the following information with us to assist in our mission.