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Dog Adoption Application
First Name
Last Name
Email Address
Phone
May we contact via text?
*
Yes
No
Address
Name of dog you are interested in adopting
Does eveyone in the home agree on adopting a new dog?
*
Yes
No
Do you understand that dogs may take 6-8 weeks to adjust to a new home?
*
Yes
No
Do you understand that adopting a dogis a life-long commitment
*
Yes
No
Are you willing to crate your adoted dog if needed?
*
Yes
No
Do you live in a:
*
House
Condo
Apartment
Do you:
*
Own
Rent
If renting, do you have pemission from your landlord to own a pet?
Yes
No
N/A
If renting, please list any restrictions:
If renting, please provide landlord's name and phone number
Is your yard fenced in?
*
Yes
No
If your yard is fenced in, is it a:
Privacy fence
Chain link fence
Do Children under the age of 18 yers old live in or regularly visit your home?
*
Yes
No
If yes, please list ages:
Please list ages of ALL adults living in the home:
If the dog is ever exposed to children of any age, as well as any visitor, will you take extra care to observe and supervise, at great length, to make sure the dog is compatible with each child/visitor and each child/visitor is respectful of the dog?
*
Yes
No
Approximately how many hours will your pet be left alone each day?
When home alone, where will your dog be?
Indoors
Free roam of the house
Gated in a portion of the home
In a dog crate
Outdoors, with shelter access
During your sleep time, where will your dog be?
Indoors
Free roam of the house
Gated in a portion of the home
In a dog crate
Outdoors, with shelter access
When home together, where will your dog be?
Indoors
Free roam of the house
Gated in a portion of the home
In a dog crate
Outdoors, with shelter access
Do you agree to a home visit prior to the approval, and/or after the adoption
*
Yes
No
Do you have other dogs living in your home?
*
Yes
No
If yes, please provide the following:
Male/Female
Male
Female
Spayed/neutered
Yes
No
If you have a second dog, please provide the following:
Male/Female
Male
Female
Spayed/neutered
Yes
No
Do you have other cats living in your home?
*
Yes
No
If yes, please provide the following:
Male/Female
Male
Female
Spayed/neutered
Yes
No
If you have a second cat, please provide the following:
Male/Female
Male
Female
Spayed/neutered
Yes
No
Do you have any other types of animals living in your home?
*
Yes
No
If yes, please provide the following:
Are these animals cages?
Yes
No
Sometimes
Are your pets up to date on their vaccinations?
*
Yes
No
N/A
Are your pets currently on any tick/flea prevention?
*
Yes
No
N/A
Are your pets current on a monthly or bi-annual heartworm preventative?
*
Yes
No
N/A
If yes, please provide name of medication:
If you answered "No" to either of the last 3 questions, please tell us why:
Please provide the name and phone number of your current veterinarian. If you do not currently have any pets, but have in the past, please list your past veterinarian.
Please provide us with a personal reference to contact:
Submit
Thanks for submitting!
On behalf of all the abandoned, abused or neglected dogs in this world, Thank you!
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