Second Chance Paws Adoption/Foster Application

Second Chance Paws Adoption/Foster Application

Must be at least 18 to adopt/foster.
Adoption fee is $175.00 to $200.00 (Includes Spay/Neuter, UTD on age appropriate vaccines and microchipped)

PLEASE COMPLETE ALL INFORMATION to ensure that this adoption is in the best interest of everyone. We do not operate on a first come first serve basis, but rather strive to make the best match between the dog and the adopter. We have the benefit of having spent time with the dogs in our homes so we better understand its needs and can determine the home that would be the best for that particular dog.

All current pets in the home must be up-to date on vaccines, heartworm prevention and Spayed/Neutered unless a valid reason from vet.
Application Date*

MonthDayYear
Today's Date
What is the name of the specific pet in our care that you are interested in?*
Please tell us why you want to adopt/foster a pet?*
Applicants Name*
Must be 18 years or older.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Work or Alternate Phone Number*

Area CodePhone Number
Email*
example@example.com
Co-Applicants Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Work or Alternate Phone Number*

Area CodePhone Number
Email*
example@example.com
Please provide the names, contact numbers and relationship of 2 local people for personal references*
If possible please list one relative not living with you
Please list below all the people that will be living with potential pet (including yourself) Name, age, relationship to prospective adopter *
Name, age, relationship to prospective adopter
I am adopting this pet for(check all that apply:)*

MyselfSpouseChildrenGiftOther
If you checked "Other" please explain
Did your entire family agree on the adoption/foster and care of this dog?*

YesNo
Have you ever: Sold, Given away, Surrendered a pet,*

SoldGiven AwaySurrendered a PetNone of the aboveOther
If yes please explain why:
Have you ever had an application denied for adoption from an animal welfare group/animal control facility?*

YesNo
If yes please explain why:
Have you, or any member of your family/household been cited for leash law violations or cruelty to animals in the past?*

YesNo
If yes please explain why:
Are you willing to have a home check prior to the approval of this application or after adoption?*

YesNo
Please list all current pets,name, breed, how long you have had them and if spayed/neutered below.*
Please list any previous pets you had below and why they are no longer with you.*
Please provide the clinic name,address and phone # of your current vet/ past pets vet. If no past pets the vet you plan to use for the pup you are wanting to adopt. (this must contain vet info or application will automatically be denied.) They will be contacted to verify information. incorrect information can result in application for adoption denied.
Clinic name and address*
Most recent or planning to use
Clinic Phone#*
Name on account and pets name.*
Are all your current dogs up to date on their vaccinations within the last 12 months?*

YesNo
What do you know about heartworms?*
Are all your current dogs given monthly heartworm preventative? Will be verified by vet*

YesNo
If so, please indicate the brand(s) of heart worm preventative. *
Brand of prevention must be stated for application to be reviewed. Failure to supply brand will halt application review and possible be denied.
Where do/did you purchase your heartworm preventative?*

Vet OfficeOnline with vet prescription
Do you plan to keep your new pet on heartworm prevention?*

YesNo
Do you live in a:*

HouseApartmentCondo/TownhomeMobile HomeOther
Do you :*

OwnRent/LeaseOther
If rent/lease please provide Landlord's/Complex name and contact information*
Landlord/Complex will be contacted to verify permission to have a pet and size/breed limitation if allowed
What will happen to your pet/pets if you move unexpectedly?*
What will happen to your pet/pets if you, go on vacation or in case of an emergency?*
What will you do if the pet becomes very ill?*

Seek Medical AttentionNothingEuthanizeOther
How many hours during an average day will your dog be home alone without a human?*
Will this dog be:*

Inside onlyOutside onlyBothOther
Where will this dog be kept during the day?*
Where will this dog be kept during the night?*
Where will this dog be kept when you are not home?*
If kept outside for any period of time, how will it be contained?*

FenceTetherChainElectric fenceRoam freeOther
Do you have a fenced in backyard?*

YesNo
If yard is not fenced, how do you plan to exercise your dog?*
What kind of behavior do you find unacceptable?*
If the dog had problems with behavior what will you do about it?*
By submitting this application: I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge. I/we also understand that completion and submission of this pre-adoption questionnaire DOES NOT guarantee adoption of a pet and SCP reserves the right to refuse an adoption. I/we hereby permit Second Chance Paws to contact my/our Veterinarian(s) and Landlord if applicable. If you are a foster to adopt, the pet remains the property of SCP. If you are unable to care for the pet immediately contact SCP. UNDER NO CIRCUMSTANCES CAN YOU REHOME OR GIVE AWAY THE PET IN YOUR CARE. If any of the above information cannot be verified I agree to return the dog to Second Chance Paws upon request. I/We*

AgreeDisagree
Potential pet parent signature (Type your full name)*
Co applicant signature required also
Should be Empty: