Pre-Adoption Application for Dogs

Pre Adoption Application – Dog

You can fill out the online form below and send it to us or download/print the form and send to us.

    Your Name (required):

    Address (required):

    City (required):

    State (required):

    Zip Code (required):

    Phone (required):

    Your Email (required):

    Dog interested in (required):

    What do you know about this breed:

    How long have you been looking for a dog:

    Have you researched this breed: YesNo

    Your Occupation:

    Hours away for work:

    Number of days work per week:

    Age:

    Do you own or rent your home: OwnRent

    What type of home do you live in:

    If you rent do you have written permission to have a dog: YesNoNot Applicable

    Do you have a fenced yard: YesNo

    What type of fence:

    How high is the fence:

    Number of people living in your home and ages:

    Anyone have any allergies to dogs: YesNoNot Sure

    Are all family members in agreement to adopt a dog: YesNo

    If you share your home with someone and unexpectedly split up, who would care for the dog:

    How much do you think it costs to own a dog for a year:

    Do you have any dogs currently: YesNo

    If so how many and ages:

    Are they current on vaccinations: YesNo

    Are they spayed and or neutered: YesNo

    Do you annually use heart worm preventative: YesNo

    Do you use heart worm prevention all year or seasonally: All yearSeasonallyNeither

    What type of dog food do you feed them:

    Have you ever had to give a dog away? If so why:

    Have you adopted a pet before: YesNo

    If so from where:

    Where would you put the dog when the family members have to leave:

    Where will the dog sleep:

    How will the dog be exercised:

    How often will the dog be exercised:

    Do you plan to take the dog to obedience training: YesNoNot Sure

    What type of issues do you expect the new dog to have at your home:
    Chewing on furnitureBarkingDiggingChasing other animalsEating plantsUrinating or defecating in houseOtherNone

    If you have issues with a new dog in your home are you willing to work on these issues:
    YesNo

    What would make you give up a pet:

    Are you willing to allow an Adopt-A-Pet representative do a home visit to see where the animal will live: YesNo

    Would you allow us to contact your current veterinarian: YesNo

    Name of Vet:

    Address of Vet:

    Phone of Vet:

    If requested do you have references we could check: YesNo

    Signature:

    Date (YYYY-MM-DD ):

    If you have anything to attach, attach it here (Limit of 5MB).