Request edit access
Millie's Mutts Adoption Form
While yes, our form is long, there are a lot of aspects that go into adopting a dog. And we want to make sure that the dog you found is the right dog for you, your lifestyle, and your family.

We ask for an email address not only for communication, but so that you can come back and edit your responses later if you should find an error or want to update a change.

Email address *
Name of the pet you're interested in adopting *
Put Foster if interested in Fostering
Your answer
About you & your household
Name *
Your answer
Your Date of Birth *
Not pets
MM
/
DD
/
YYYY
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home Phone
Your answer
Work Phone
Your answer
Cell Phone
Your answer
Best phone for contact *
Place of Employment *
Your answer
Proximity of your home to your place of employment
Your answer
Name(s) & relationship(s) of other adults in household *
If no one else lives with you put "NONE"
Your answer
Adoption
How many times have you applied for adoption in the past year? *
Your answer
What was the outcome of the application & why? *
Your answer
Why are you interested in adopting a pet? *
Your answer
What characteristics are important to you in a pet? *
Your answer
Do any family members have allergies to( Click those that apply): *
Required
Are ALL family members in agreement about the adoption of a pet? *
Will this pet primarily be kept: *
When outdoors, will the pet be: *
Where will this pet be kept during the day? *
Your answer
How many hours will this dog be left alone? *
Required
Who will care for this animal when you are out of town? *
Required
Do you own a truck or Jeep? *
If yes, where in this vehicle will your pet ride?
Your answer
What type of area is your home located in? *
Do you own or rent? *
If renting, are you allowed to have pets? *
Property Name
Your answer
Property Manager's Name & Number
Your answer
Pet Deposit Fee Amount
Your answer
Do you have a secure, fenced-in yard? *
What type of fence do you have? *
If no fence, how do you plan to exercise your pet? *
Your answer
Do you have a pool? *
What is your family's activity level? *
Required
Are you prepared for the financial responsibility of owning a pet: *
Non-human household members
Do you have any current pets? *
If so, please list there name(s), type, breed, sex & age *
Your answer
Are they spayed/neutered *
Are they current on shots? *
Are you familiar with heart worm disease? *
Are they all on heartworm preventative medicine? *
If using heartworm prevention medicine, what brand are you using?
Your answer
Other than your current pets, please list your previous pets during the last 10 years. Name(s), Type of Pet, Breed, Sex, Reason they are no longer with you, spayed/neutered status *
Your answer
Have you ever given up an animal or gotten rid of an animal? *
If yes (or other) please explain the reason and what you did with the animal.
Your answer
Do you give MMR permission to contact your veterinarian? *
What is your veterinary care providers phone number? *
Your answer
Miscellaneous Questions
If adopting a puppy, have you adopted a puppy before and are you aware of the extensive care and attention they require at a young age? *
If adopting a pet that is not yet house-trained, do you realize that you'll be responsible for house-training him/her? *
Are you familiar with crate-training? *
Would you use it? *
How will you handle it if your animal chews furniture or displays destructive behavior. *
Your answer
Do you plan to take your pet to obedience training? *
Do you have a set limit as to how much you will spend on your pet to save his or her life? *
What would be your limit to spend to save your pet's life? *
Your answer
Please list a personal reference and phone # that we may contact if needed. *
Your answer
Any comments that you would like to add?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms