UAFW Adoption Application

Urgent Animals of Fort Worth

Adoption Application
Urgent Animals of Fort Worth, Inc is a 501(c)(3) nonprofit animal welfare organization. We are dedicated to the rescue and placement of Fort Worth shelter animals. All of our pets are cared for in volunteer foster homes and receive complete medical care including vaccinations, spay/neuter and microchip prior to their adoption.

This questionnaire is designed to help Urgent Animals of Fort Worth and yourself determine if a specific pet is compatible for you and your household. All adopting parties are required to complete this form prior to adoption. UAFW reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions.
Applicant Information
Name of the pet you are interested in:*
Applicant name:*
Your age:*
Co-applicant name:
Street Address:*
City, State, Zip*
Phone number:*

Area CodePhone Number
Phone type*

CellHomeWork
E-mail:*
Employer:*
Character reference and phone number:*
How long have you been looking for a new pet? *
Are you in contact with any other rescues or shelters about a specific dog?*

Yes, application is pendingYes, inquiry made but no application has been submittedNo, but I am looking at several pets onlineNo, I am only interested in this pet
When will you be ready to adopt?*

Within a weekWithin a monthNot ready yet, just researching
Are you familiar with pet regulations in your area?*

YesNoI live in an unincorporated area where there are no pet regulations.
If yes, please describe local pet regulations and restrictions:
Household Information
Are all members of your household in agreement with this adoption?*

YesNo
Who will be the pet's primary caregiver?*
Do you work outside of the home?*

YesNo
How many hours per day will the pet be left alone? Please explain.*
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?*

YesNoNot applicable
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Residence Information
Dwelling type:*

Single family homeApartment/CondoMobile HomeOther
Approximate square footage:*

Less than 800800-10001000-15001500-2000Over 2000
Do you have a fully fenced yard?*

YesNo
Fencing type:

Vertical, height less than 4 feetVertical, height 4 feetVertical, height 6 feet or moreInvisibleOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision?*

Breed restrictionsNumber of petsSize or weight restrictionsNone
Current/Previous Pet Information
List any current pets, their breed, gender, age:*
Are all current pets spayed/neutered and up-to-date on vaccinations and heartworm prevention?*

YesNoNo current pets
If no, please explain why:
Please provide the name and phone number of your current and/or previous veterinarian or clinic.*
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?
New Pet Information
Which type of personality do you want your new pet to have:*

Low energy - walks slowly on leash; a total couch potatoMedium energy - plays a bit, then hangs out with youHigh energy - wild and crazy is cool!
Which describes the type of pet you want to adopt? Please check all that apply.*

A family petTo breedTo train/use for huntingType To train/use for agilityTo train/use as a therapy dogTo train/use as an assistance dog for the disabledTo use as a guard dogFor a jogging/hiking partnerTo interact with lots of friends/familyAs a gift for a friend/family memberAs a companion for my dog(s)As a companion for my cat(s)As a companion for my child/childrenOther
Please check all that apply regarding your adopted pet:*

Kept indoors most of the timeTo be kept outside most of the timeKept on a lead line/cable in the yardLeft outside during the work day while we are awayKept inside while we are awayCrated when we are not homeHave free reign of the house when we are not homeWill attend formal group obedience classesHave private sessions with a trainer as neededBe trained by us without the advice of a trainerMust be housebroken prior to adoptionWill be housetrained by usWill attend agility classesTaking frequent car rides with usMostly interacting with adultsInteracting frequently with children under age 8Interacting frequently with older childrenWill be walked occasionallyWill be walked more than one mile per day, every dayA jogging/hiking partnerWill be going camping with usWill go boating with usTo be boarded when we go on vacationWill stay with family when we go on vacationOther
Where will your new pet sleep at night?*
How will you supervise the pet's outdoor activity?*
Have you ever housebroken a dog or puppy before?*

YesNo
If the pet has an "accident" in your home, what type of correction do you plan to use?*
Are you aware of crate training?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may temporarily exhibit uncharacteristic behavior?*

YesNo
Are you willing to work through your new pet's issues, if any?*

YesNo
Do you plan to take an obedience class with your pet?*

YesNoNot sure
If yes, where?
Please take time to think and be honest with yourself and us. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the pet?*

HousebreakingChewingJumping on peoplePulling on leash during walksCounter surfingObedience trainingFear of menFear of womenFear of childrenSeparation anxietyMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my pets or childrenHigh activity levelFood/toy aggression, not willing to share with other dogsFood/toy aggression with peopleWhining/cryingHeart conditionDiabetesLimited sightBlindnessDeafnessIncontinence/leaking urineLong term medicationGets stressed or carsick in vehiclesDoesn't know how to climb stairsCan't climb stairs due to age, arthritis, or health issuesSkin allergiesFood allergiesYeast on coat or in earsTrimming nailsEar mitesFleas/ticksSpecial dietMonthly heartworm preventativeAnnual vaccinationsOther
How do you plan to integrate this pet into your home/family?*
What do you feel is a reasonable amount of time for a pet to adjust to life with you/your family?*
Do you understand that a pet can likely be an 15-18 year commitment?*

YesNo
What would you do if after adoption (at any time during the life of the pet) that your vet diagnosed an expensive health condition? *
What circumstances would lead you to give up your new pet?*
If you had to give up your pet, what would you do with him/her?*
What brand of pet food do you plan to feed?*
Grooming (please check all that apply):*

We use a professional groomerWe trim dog nails ourselves at homeWe bathe our dogs at home once a weekWe bathe our dogs at home once a monthWe bathe our dogs at home once every few months or whenever their coat feels dirtyWe don't bathe our dogWe check ears weekly for infection/yeast/mitesWe check coat daily for ticks in spring/summer/fallWe clean teeth using home methodsWe take our pets to the vet for dentals whenever the vet recommends this is neededPrefer a dog that doesn't shedDon't care about shedding
How much do you feel is a reasonable amount for yearly expenses on your new pet?*
How much do you feel is reasonable for an unexpected medical expense for your new pet yearly?*
Do you plan to get pet health insurance?*

YesNoI wasn't aware this was available. I will look into it.
How did you find out about Urgent Animals of Fort Worth rescue?*

FacebookUrgentanimalsfw.orgAdopt-a-Pet.comPetfinder.comFriend/Family memberOther
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Enter the message as it's shown*
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Urgent Animals of Fort Worth

Applicant Information

Household Information

Residence Information

Current/Previous Pet Information

New Pet Information