Dog & Puppy Adoption Application

DOG/PUPPY ADOPTION APPLICATION

Are you ready to adopt a canine friend? Please complete and submit our online Dog/Puppy Adoption Application form. We will be in touch with you shortly.

Date

Month

Day

Year

Name of dog/puppy

Why do you want to adopt this dog/puppy?

Please share the reason(s) you wish to adopt this dog/puppy? (250 characters)

Your required information:

First name

Last name

Email

Cell Phone

Alternate Phone

Street Address

Address Line 2 / Apt. No.

City

State

Zip Code

Please select from one of the following:

Please tell us about your living situation:

I am a homeowner

I am a renter

Other

How many people are living in your home?

I live by myself

I live with an adult and/or child

Other

Your New Pet's Environment

Where will the dog/puppy be kept?

Indoors

Outdoors (in a safe and secure enclosure)

Both

Who will take care of the dog/puppy when you leave town?

Pet will be my companion

Family/Friends

Boarding Facility

Pet Sitting Service

How many hours will the dog/puppy be left alone during the day?

Seldomly - No of _______hours

During the day - No of ______hours

During the night - No of ______hours

Where will the dog/puppy be kept during the day?

Where will the dog/puppy be kept during the evening?

Veterinary Information

Name of veterinary clinic

First Name

Last Name

Street Address

Street Address / Apt. No.

City

State

Zip Code

Phone

Email

Commitment to your pet

Are you willing to give this dog/puppy the time needed to destress and settle into a new environment?

Yes, as much as it takes.

I will wait to see how it goes.

What dog/puppy behaviors or life changes could make you unable to keep the dog/puppy? (Examples: aggression, housetraining, divorce, job loss, moving, or children.) Maximum 750 characters.

If behavioral issues arise, are you willing to seek professional guidance and put in the time and training needed to work through them?

Yes

No

Signature

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