Select Pet Name
Abbey (Dog - D2410114)
Alexa (Dog - D2302020)
Benny (Dog - D2411116)
Chessie (Dog - D2411119)
Conrad (Dog - D2411120)
Courtney (Dog - D2408092)
Delta (Dog - D2410111)
Dusty (Dog - D2305088)
Francis (Dog - D2410109)
Jamie-Lee (Dog - D2406093)
Loki (Dog - D2411124)
Luna (Dog - D2408094)
Niko (Dog - D2303044)
Patches (Dog - D2311173)
Pumpkin (Dog - D2408090)
Sassie (Dog - D2407096)
Thor (Dog - D2411123)
Type pet name(s) of others interested in.
Individual or Couple *
Individual
Couple
Primary First Name *
Primary Last Name *
Primary Cell Phone *
Home Phone
Primary Email *
Secondary First Name *
Secondary Last Name *
Secondary Cell Phone *
Secondary Email
Street Address *
City *
State *
AR
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
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NH
NJ
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NY
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ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip *
Why do you want to adopt this pet?
Companion for you
Companion for other family member
Companion for other pet
Protection
Hunting
Service pet
Current Veterinarian's Name, Phone Number *
If you have never had a pet before please list the vet that you will likely use.
Previous Veterinarian's Name, Phone Number
How many people in household? List ages of each *
Number of adults & children
Include ages for all
Primary Caretaker *
Do all members of household want to adopt this pet? *
No Yes
Do you own your home? *
If no, please provide landlord's name and phone number
Type of Residence *
House, Townhouse, Condo, Mobile Home, Other
How long at present residence? Do you plan on moving in the near future?
Please explain *
Fenced yard *
No Yes
How do you rate your pet experience?
First Time Owner
Beginner
Intermediate
Advanced
Please list the pets in household now, age, breed, & sex: Are they vaccinated? Spayed/neutered? On heartworm prevention?
List Pets *
Tell us about any pets you have owned in the past 10 years: What happened to these pets?
List past pets *
Will pet wear collar and ID tag? *
No Yes
Are you aware pet may not be trained? *
Are you aware that a rescued pet may not be fully housetrained?
No Yes
Are you willing and able to housetrain the pet? *
Are you willing and able to housetrain the pet?
No Yes
How will you handle behavioral issues? *
Would you be willing to take the pet to obedience training?
How to you plan to exercise pet? *
How many hours a day will this pet spend without humans? *
Do you have someone to take the pet out, if needed? *
if more than 8 hours, do you have someone to take the pet out? Explain.
When will the pet be inside? *
All the time, at night, In and Out, Never
Where will the pet sleep at night *
Which of the following behavioral issues would prompt you to give up your pet? Check all that apply:
Excessive Barking
Biting/Scratching Family Member
Poor Guard Dog
Not Friendly with Guests (barking, hiding)
Aggressive with Dogs/Cats
Biting
Chewing on Furniture or Carpet
Shedding
Problems with Housetraining
None
Which of the following reasons would prompt you to give up your pet? Check all that apply:
Moving
Having a baby
Allergies
Divorce
New Spouse/Partner doesn't Like Pet
Financial Problems
Pet's Health Problems
Excessive Veterinarian Bills
None
Would you agree to a home visit by an Out of the Woods representative? *
No Yes
If there is any other relevant information you would like us to know *
Initial Here *