CARE Dog Adoption Application

Dear applicant:

Thank you for your interest in adopting from us! We are an all volunteer, no-kill, 501C3 animal rescue/shelter servicing the Southcoast Region of Massachusetts. We focus our efforts on older animals, sick animals, animals with behavioral issues that would not make it in a traditional shelter, but will take in any animal requiring assistance. Our mission is to place all of our animals in loving, permanent homes. You are not purchasing a pet from us; you are adopting a living, breathing, creature that deserves safety, love and care. Your answers to this questionnaire are assurance to us that the animals we care for are going to good, permanent homes. All of the information on this application is confidential.

We do not use a first-come, first-serve process when adopting out dogs. Instead, we focus on best fit for each individual dog. The process is intended to ensure a long-term successful adoption for both the family and pet.

Dogs can live for 10-20 years, so please make sure your lifestyle allows the time, patience, and ability to cover expenses your new dog will need over the years. Will you be travelling frequently, moving soon, or having children? Do you have a job that keeps you away from home for long hours during the day? Responsible dog ownership includes as-needed and routine veterinary care, daily walks, exercise, quality food, preventatives, and other supplies. You must be at least 21 years old to adopt.

All of the dogs and puppies available for adoption are fully vetted, which includes a complete veterinarian checkup, spay/neuter, deworming, Advantage II flea treatment, distemper and rabies vaccines. At times, these dogs may require other health related attention, which which we also take care of, prior to adoption.

The adoption fee is $400 for puppies and young dogs under 2 years, $350 for 2-7 years, $300 for seniors 7 years and older. The adoption fee is subject to change based on the cost of care that went into preparing the dog for adoption.

Name of Applicant *

First Name Last Name

Age of Applicant *

Applicants must be at least 21 years old to adopt

Name of Co-Applicant

First Name Last Name

Email Address *

Cell Number *

Area Code Phone Number

Alternative Phone Number

Area Code Phone Number

Employment *

Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

What type of dog are you interested in adopting? Check all that apply. *

Puppy Adult Senior Undecided / no age preference

Are you interested in adopting a specific dog? *

Yes - I am applying for a dog I saw on Petfinder Yes - I am applying for a dog I met in foster care Yes - I am applying for a dog that I saw on Facebook No - I am still considering all options that might be a good fit

Which dog(s) are you interested in adopting? *

List the name(s) of all dogs you're interested in

Describe the type of personality and/or appearance you would like your dog to have: *

Ex: playful, friendly, good with kids, good with other dogs, male etc.

If the dog(s) you are interested are no longer available for adoption, would you like us to continue to process your application for pre-approval in the event that another dog that interests you? *

Yes No

Who is this pet for? *

Myself My family Relative Friend Other

Are all members of the household aware of the adoption and in agreement? *

Yes No

Have you applied to adopt from CARE Southcoast previously? *

Yes No

Have you adopted from CARE Southcoast previously? *

Yes No

Are you looking to adopt now, or in the future? *

If future, please provide an estimate as to when you'll be ready to bring home your new dog

Describe your home *

Single-Family Apartment Condo/Duplex Public Housing Student Housing

Do you own or rent your home? *

Own Rent I live with a parent, guardian or family member

If you rent or live in a family member's home, please provide their contact information here:

Ex: Landlord - Becky Allen (111-111-1111)

Who else lives in the home or visits regularly? Please list names and ages for individuals under 18 years of age. *

Ex: Michael, husband (41); Jessica, daughter (7). Susan, mother-in-law (80).

Is your home busy or quiet? *

Busy Quiet A mix of both, depending on the time & day

Are any members of the household allergic to pets (eg. dogs, cats etc.) *

Yes No

If you had to move, are you willing to find housing that accepts pets? *

Yes No Maybe

Does your home have a yard? *

Yes - front & back Yes - just front/back No

Is your yard fenced? *

Yes No

How do you plan to exercise your dog and allow it to relieve itself? *

Provide detail

Do you have any pets currently? *

Yes No

List all current household pets:

Name

Type of Animal

Sex (M/F)

Age

Fixed? (Y/N)

Up-to-date on vaccines? (Y/N)

Pet 1

Pet 2

Pet 3

Pet 4

Pet 5

Have you had any pets of your own in the past 10 years? *

Yes No - this is my first pet

List all previous pets that you no longer have (within last 10 years):

Name

Type of Animal

Sex (M/F)

Age

Why don't you have them any longer?

Pet 1

Pet 2

Pet 3

Pet 4

Have you ever had a pet euthanized? *

Yes No

If yes, please explain the circumstances:

Are you willing/able to take your pets to yearly check-ups? *

Yes No

If your pet becomes ill, are you able to afford a veterinary bill? *

Yes No

How many hours per day would the dog be alone? *

Do you plan to crate train your dog? *

Yes No It depends/I am undecided

Where will your dog live primarily? *

Indoors Outdoors Both indoor & outdoors

If your dog will be kept indoors & outdoors, please provide more detail on when you'd keep them indoors vs. outdoors: *

Ex. Would it be seasonally? Do you have a dog house or outdoor shelter? Would they be chained up?

How many times do you plan to walk your dog each day? *

How would you deal with behavioral issues such as excessive barking, destructive behavior, inappropriate urination etc.? *

Does your home have space (i.e. a spare bedroom, office, or bathroom) to separate new pets from current pets during the acclimation and introduction period? *

Yes No

Are you willing to give your dog time to adjust to its new environment? (Note: this could take anywhere from several days to several months) *

Yes No

If you have to leave town, urgently or planned, where would your dog stay or who would take care of it? *

If you were no longer able to care for your dog, or had to move, what would happen to your dog? *

Have you ever had to re-home a pet or surrender it to an animal shelter, animal control etc.? *

Yes No

If you answered "Yes" to the above question, please explain the circumstances:

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment? *

Yes No

If you answered "Yes" please provide a detailed description:

Are you willing and able to care for your dog for the full duration of its life (10-15+ years)? *

Yes No

Vet Clinic *

Area Code Phone Number

Last name that the pet(s) are listed under (if applicable): *

Previous Vet Clinic

Area Code Phone Number

Reference 1 *

First Name Last Name

Reference 1 *

Area Code Phone Number

Relationship to Reference 1 *

Ex. Neighbor, coworker, roommate, family friend

Reference 2 *

First Name Last Name

Reference 2 *

Area Code Phone Number

Relationship to Reference 2 *

Ex. Neighbor, coworker, roommate, family friend

I certify that I am at least 21 years of age *

Agree Disagree

The information I have provided on this application is true. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from CARE *

Agree Disagree

I understand that CARE has the right to deny any application for any reason *

Agree Disagree

I understand that CARE is not able to guarantee the health or temperament of any dog, as many dogs come in with unknown histories. There are traits that could change upon adoptions and I take responsibility to care for and address these issues if they do arise *

Agree Disagree

I understand that anything could happen in life, and if I find that I am no longer able to care for my adopted dog, I agree to contact CARE by phone and/or email to discuss return/or need for help of the adopted animal *

Agree Disagree

I understand that I am to immediately contact CARE in the event that my adopted dog is lost/missing *

Agree Disagree

I attest that the dog I am adopting is for me, in my home, and NOT a gift for anyone *

Agree Disagree

I understand that I am responsible for paying for all follow-up vaccines, wellness visits & medical procedures my pet will require in the future. *

Agree Disagree

I hereby authorize CARE Southcoast to contact my references, veterinarian(s), and landlord to verify said statements.

Signature of Applicant *

First Name Last Name

Date *

Date

Dog Adoption Application

General Information

Home & Family

Current & Past Pets

Veterinarian

Personal References

Terms & Conditions