FCHS Dog Adoption Questionnaire

Thank you for considering adopting a dog from Floyd County Humane Society! Pet adoption is an exciting time and a serious commitment that the entire household needs to consider and agree to before the animal is adopted. We want to ensure that each adoptive household is aware of, and willing and able to accept, the physical and financial responsibilities of pet ownership. This questionnaire will help both you and us find the perfect companion to add to your family. We are a small, volunteer-led organization. Please allow our volunteers time to carefully review and process all questionnaires. We will contact you as soon as possible to answer any questions you have. If you have questions about the adoption process, please call us at 540-745-7207. (Fields with a red asterisk are required.)
Personal information
First Name *
Last Name *
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number *
Email Address *
Are you 18 years or older? *
Applicants under 18 are welcome to participate in the adoption process, but only with a parent or legal guardian completing the application and serving as the animal’s legal adopter.
What's the best way to reach you?
Is there a particular dog you are interested in? If so, who?
Dog's name
Home information
Tell us about the pets you currently have at home. *
Do you rent your home? *
We welcome adopters who rent or live in an apartment or condo. We want to alert you that some landlords and management companies may have size and breed restrictions, limits on number of pets, and/or require pet deposits or additional fees. Please let us know if you need assistance navigating a conversation with your landlord or have other questions.
Describe your home’s activity level
Activity level:
Caring for your dog
Will the dog you adopt mostly live inside, outside, or both?
Are you and family willing to work with the dog to overcome potential challenges like barking, digging, scratching, or getting along with your other pets and family members?
Do you have family/friend support in case you have to be gone for an extended period of time?
Medical care
How will your dog recieve medical care? If you have a trusted vet, include their name and contact information.
Closing questions
Have you ever been charged or convicted of animal cruelty, neglect, or abandonment? *
Where did you first hear about this dog?
Other:

What topics would you like to discuss with FCHS volunteers?	Feeding your pet Introducing this pet to other pets House-training Finding a trainer Flea/tick/heartworm prevention Finding a veterinarian Crate-training Estimated cost of dog ownership Plan for bringing dog home Grooming/nail trimming Working with puppies

Other questions or information you'd like to share:

If at any time an adopter cannot keep the dog, it must be returned to the Floyd County Humane Society. In case of return, the adopter is responsible for the arrangements and cost of caring for and transporting the dog until FCHS can secure foster care or shelter space. If the dog is not spayed or neutered at adoption, the adopter is required to alter the dog and provide a veterinary certification of procedure to the Floyd County Humane Society by the date specified in the adoption contract. Dogs not spayed or neutered by the contractual date may be seized.
Please sign (with mouse or fingertip) *
Date

Updated February 19, 2026