Which dog are you interested in meeting/adopting?

Please list ALL dog(s) you're interested in - *

How did you hear about us?

First Name *

Last Name *

Email *

Home Address *

City *

State *

Zip Code *

Home Phone *

Work Phone

Cell Phone

Best Time to Call

Are You Over 21 Years Old? *

Hours Worked Per Week *

Number of People Living in Household *

Is everyone living in the household in agreement about adopting the dog? *

Members of Household: Please list names, relationship and age. *

Whose responsibility will it be to feed, water and care for the dog? *

Do you anticipate any significant changes in the next year? Check all that apply

What plans would you have for the dog if any of the above occur?

Do you have a long-term plan in place if you were no longer able to care for the dog or if the dog outlives you? (Please explain) *

Please list any current pets you have, name, type, age, spayed or neutered, length of time owned and if they are current on vaccinations?

What brand of heartworm prevention are your current dogs on?

Do your other pets get along with dogs?

Are you willing to have your current dog(s) meet the new dog?

Have you had any other pets in your adult life?

IF YES, how long did you own them and what happened to them?

What kind of traits are you looking for in a dog?

What do you consider undesirable traits?

What breed / mix do you prefer?

Do you have prior experience with these breeds during your childhood or as an adult? If so, please explain:

What is the approximate adult weight of the dog you are looking for?

What is the activity level of the dog you are looking for?

What gender do you prefer?

Reason for gender preference?

Would you be willing to housetrain / crate train your new dog? *

Do you need for your new dog to be good with children? *

What type of home do you live in? *

IF OTHER, please explain:

Do you own or lease? *

IF LEASING, do you have permission to own a pet? (Proof of pet deposit and / or landlord approval will be required)

IF LEASING, are you aware of any pet restrictions?

IF RESTRICTIONS, please explain:

Landlord Name

Landlord Phone Number

Is your yard SECURELY/FULLY/PROPERLY fenced? *

IF YES, what type of fence is it? Check all that apply:

IF OTHER, please describe:

What is the height of the fence?

Do you have a swimming pool?

How many hours a day do you plan to share with the dog?

What role will this dog play in your life? Check all that apply: *

IF OTHER, please explain:

What activities do you plan to share with the dog?

What training are you interested in doing with the dog?

Where will the dog be kept during the day? Check all that apply:

IF OTHER, please explain:

Where will the dog be kept at night? Check all that apply:

IF OTHER, please explain:

Who will care for the dog when you travel or problems occur that make you unavailable?

How will you transport the dog?

What brand of food will the dog eat?

On average, how much do you expect to spend annually on this dog? (including food, routine and emergency vet care, grooming, toys etc.)

Heartworm Information Heartworms are parasites transmitted by mosquitoes to your dog. They live and grow in the heart, eventually producing enough worms that the heart can no longer function and the dog dies. Treating a dog for heartworms is both expensive ($500-$1000) and very hard on your dog’s system because the treatment used to kill the worms can be fatal. Heartworms are, however, very easily prevented with a monthly heartworm preventative. Your dog will need to be on heartworm prevention for the rest of its life. Are you willing to commit to this level of care? *

At minimum the dog will require a yearly vet exam and vaccinations. Often dental care and other procedures may be required. Are you committed to this level of care for the rest of the dog’s life? *

There are times when unexpected and often very expensive medical conditions occur. Are you committed to providing whatever medical care your veterinarian deems necessary for you dog? *

Veterinarian

Veterinarian’s Phone Number

What will you do if the dog displays bad behavior such as barking, digging, chewing, etc? *

What would you consider a legitimate reason for “giving up” a dog? *

Adoption Application