Dog Adoption Application
Please fill out this form honestly, and email RrrrescueMaria@gmail.com with any questions.
Email address *
First Name *
Your answer
Last Name *
Your answer
Age *
Your answer
Driver's License State, # and Expiration Date *
Your answer
Address *
Street Address + City, State, Zip and Apartment number if applicable.
Your answer
Phone Number *
Your answer
We sometimes require home visits. May we visit your home?
Do you rent or own?
Which dog would you like to adopt?
Your answer
Who will be the primary caregiver for the dog?
Your answer
What do you know about heartworms and heartworm prevention? *
Your answer
Does anyone in your home have allergies or asthma?
Your answer
Occupation and Employer?
Your answer
What would cause you to give up a dog? *
Required
Who is your current Veterinarian?
Your answer
Do you have children? What are their ages? *
Your answer
Do small children often visit your home? *
Are you able to afford yearly vet visits for vaccinations and checkups? *
Are you aware that dogs can live up to 15+ years? Can you care for a dog for that long? *
Your answer
Would you be willing to adopt a dog with special needs?
(amputated limb, blind, deaf, old age, needs daily meds, etc)
Your answer
If something were to happen to you, who would take care of this dog? *
Your answer
Are you able to afford emergency medical attention if needed? *
Your answer
Where will this dog live? *
List any other pets in your home, their species, breed, and age. *
Your answer
When was your last visit to the vet and why?
Your answer
Have you already gotten supplies for this dog?
Your answer
How will you deal with behavior problems?
Your answer
If you have other pets, how will you introduce your new dog to your household?
Your answer
Where did you find this dog? *
Contract *
Required
Please Type Your Name Below *
By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Your answer
A copy of your responses will be emailed to the address you provided.
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