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).