Adoption Questionnaire

In order to be considered for an adoption, you must:

Be at least 21 years of age.
Have legal identification with your current address.
Be able to verify that you are allowed to have a pet where you live.
Must provide veterinary and personal references.
Be able and willing to devote the time and expense necessary to provide training, medical treatment, and properly care for the pet.
Understand that the Town/Dog Control Officer/adoption facility reserves the right to deny the adoption of any pet for any reason.
Be willing to pay an adoption fee based on the cost of medical care provided for the animal while owned by the Town.
Be willing to agree to a home visit prior to adoption.

Animal guardianship is a major responsibility that should not be taken lightly. In our ongoing effort to find the best possible permanent home for each of its animals, we ask that you complete this questionnaire honestly and in detail. You will be contacted by one of our representatives to discuss your application.

Name of the dog you are interested in:*

Your First and Last name:*

Your age:*

Street Address:*

City, State, Zip*

Home Phone:*

Area CodePhone Number

Cell Phone:*

Area CodePhone Number

Name of Employer:*

Number of years with current employer:*

Work Phone:*

Area CodePhone Number

E-mail:*

Email Address

Do you have a veterinarian?*

YesNo

If yes, please list name, address and phone number. If no, please explain why?*

List a personal reference (First & Last Name, Phone Number, Email) *

Are all members of your household in agreement with this adoption?*

YesNoDon't Know

Who will be the pet's primary caregiver?*

Do you live in a*

Do you own or rent?*

OwnRent

If rent, provide name and phone number of landlord:*

Does your landlord allow dogs?*

YesNoN/A

Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone

Do you have a fully fenced yard?*

YesNo

Height and type of fence*

Do you have any of the following?*

Electric FenceKennelDog RunNone

Please list all ADULTS over 18-years who live in the household (name / phone number / relationship to applicant) *

Please list all CHILDREN under 18-years who live in the household or who will interact with the foster animal (name / age / relationship to applicant)*

Have your children been around animals before?*

YesNo

If yes, what types of animals/breed? *

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

YesNo

List any pets you own or have owned in the past as well as species/breed and ages?

How many of these pets are spayed/neutered?*

Where are these animals now?*

Have you adopted from an animal rescue group before?*

YesNo

If yes, what group?*

Have you ever given up a pet?*

YesNo

If yes, what were the circumstances?*

What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*

Are you willing to crate train?*

YesNo

Have you ever house-broken a dog or puppy before?*

YesNo

What type of training do you believe in for your pet? (i.e Balanced training, Positive reinforcement) *

If the dog has an "accident" in your home, what type of correction do you plan to use?*

How many hours each day will your new pet be home alone?*

Where will your new pet sleep at night?*

How will you supervise the dog's outdoor activity?*

Where will your new dog stay when nobody is home?*

What length of time will you allow your new pet to adjust to his new home?*

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

YesNo

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

YesNo

What behaviors can you NOT tolerate in a new pet?*

Please add any additional information or comments below:

PLEASE NOTE: We choose an adopter based on BEST FIT for the animal and NOT a "first come, first serve" basis. If you do not hear from us within 48 - 72 hours, your application may have not be choosen for the specific animal of interest. Applications with incomplete or unanswered questions will be denied.

Adoption Questionnaire

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information

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