Dog Adoption Application
Please answer all required questions. Failure to do so will result in an automatic rejection of this application. The Ocooch Mountain Humane Society reserves the right to reject any application that is submitted. In order to become a candidate to adopt you must:
  • Be at least 18 years old
  • Have knowledge and consent of all adults living in your household
  • Have a valid proof of address
  • Understand that OMHS reserves the right to refuse the adoption of any animal

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Name *
Street Address *
City *
State *
Zip Code *
Home Phone Number *
Work Phone Number
Cell Phone Number *
Email Address *
Driver's License
Date of Birth *
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Pet's name you are interested in adopting *
Do you *
Is the dwelling a *
Does your landlord allow you to have pets? *
Name of Landlord and phone number "if renting"
How long have you lived at your residence? *
Are you planning on moving in the next 6 months? *
How many people live in your household? *
What are the ages if of any children? "if children are present"
Is anyone allergic to animals? *
Are all people in your household aware you are adopting a pet? *
Is the dog you are planning to adopt going to be a gift for someone? *
Why do you want to adopt this pet? *
Have you adopted a pet from OMHS before? *
If yes, what happened to the pet?
Have you ever surrendered an animal to the humane society? *
If yes, please explain why.
Do you currently have a veterinarian clinic you plan to utilize? *
If yes, please list the clinic you plan to utilize and the address.
Please list the animals that you have owned in the past 5 years and include the following information: Name, Breed, Age, Spayed/Neutered, Current on Vaccinations "Y/N" and What Happened to your pet. *
Are all the animals you have now up to date on their rabies and distemper vaccination? *
Are you prepared to assume the financial responsibilities of providing your dog with adequate food, exercise, medical care, etc "Illnesses and injuries can add up quickly sometimes hundreds of dollars" *
Will this dog be an inside dog? *
Which best describes the time you are home? *
When you are not home, the dog will be *
What is the activity level of your household? *
What is your past experience with dogs? *
Are you aware of the vaccinations and licenses required by law? *
Are you aware of any ordinances in your county/township concerning companion animals? *
Have any present or former pets bitten another person/animal? *
If yes, what action was taken?
What type of food do you intend to feed your dog? *
How often will you feed your dog? *
It may take your new dog a month or longer to adjust to its new home. Are you prepared to allow this much time? *
What are habits that you consider as ideal habits of a dog? *
What are habits that you cannot tolerate from a dog? *
How did you hear about our adoption program? *
Please list two personal references that are not related to you nor live in the same household. Include their name, phone number, and best time to contact them. *
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