Adoption Application

Name of Animal interested in. *

Applicant's Full name *

Spouse/Partner name

E-Mail *

Phone Number *

Address *

How long have you lived at this address? *

Are you at least 21 years of age or older? *

Can you provide a veterinary reference *

If so please provide name of Veterinary *

Your Occupation *

Does your job require you to move frequently? *

What is the reason you want to adopt this animal? *

How did you find out about us? *

Are you the decision maker about adopting this dog? *

Do you own your home? *

Is this pet for you or someone else? *

Do you own other pets at the current time? *

If yes, please list their names, breeds, and ages.

Are all of your pets spayed/neutered/fixed? *

Are your pets current on their vaccinations? *

Have you ever turned your dog or cat into a shelter? *

If yes, please explain? *

Veterinarian's Name *

Veterinarian's Address, City, State, and Zip Code *

Veterinarian's Phone Number *

Have you ever had a pet euthanized? *

If yes, please explain:

Have you ever re-homed a pet? *

If yes, please explain: *

How do you feel about having pets spayed/neutered? *

Are you familiar with heartworm and heartworm prevention? *

If you have pets, will they adjust to a new pet in the house? *

Were any of your pets obedience trained? *

Please check the main reason you plan to adopt a pet: *

If you answered "other" above, please explain here:

Please describe in detail the pet you are looking for. *

Do you own or rent your home? *

Please select your current residence type. *

If you answered "other" above, please explain here: *

How long have you lived at this address? *

If you rent, does your landlord and lease allow pets? *

Including yourself, how many people live in your household? *

Please list the ages & relationship of those who live in your home. *

Is everyone in your household aware that you are planning to adopt a pet? *

Does anyone in your household have allergies to dogs/cats? *

Employment Status *

If you chose "other" above, please explain: *

If you are employed, what is your current occupation? *

On average, how many hours per day will your pet be left alone? *

How much do you think the annual medical bills will be for your pet? *

What would you do if the bills went over this amount? *

Will this pet be predominantly living inside, outside, or both? *

Please provide a description of this pet's living conditions. *

Do you have a completely fenced-in yard? If so, what kind of fence? *

If you answered "other" above, please explain: *

If you do not have a fenced yard, how will you let the animal out? *

Where will the animal sleep? *

If you answered "other" above, please explain: *

Do you have a pool? *

Is there a fence around the pool? *

What kind of fence do you have around your pool? *

If you answered "other" above, please explain: *

What do you know about potty training/housebreaking? *

How will you handle destructive behavior? *

Will you keep the animal up-to-date on vaccinations and heartworm preventative? *

If no, please explain: *

Are you willing and able to exercise the dog on a regular basis? *

If yes, what is the method of exercise? *

If you answered "other" above, please explain: *

What arrangements will you make for the care of your pets in case of an emergency? *

If you answered "other" above, please explain: *

What will you do with the animal when you go on vacation? *

If you answered "other" above, please explain: *

For what reason(s) would you consider returning/giving up the animal? *

What would you do with your animal if you had to move? *

If you answered "other" above, please explain: *

Are you willing to take responsibility for this animal for the next 10-20 years? *

If no, please explain: *

Will you allow us to perform home checks? *

I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *