Helping Paws Adoption Form
Email address *
Date *
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ID and Name of Desired Pet (if known)
Your answer
Your First Name *
Your answer
Your Last Name *
Your answer
Your Street Address *
Your answer
City, State, Zip Code *
Your answer
Your Email Address *
Your answer
Best phone # to reach you *
Your answer
Best time to call *
Your answer
Place of employment + your phone # there *
Your answer
Spouse place of employment (if applicable)
Your answer
How did you hear about Helping Paws? *
Your answer
What distance are you willing to travel to pick up your dog? *
Your answer
All humans by name and ages (we don't adopt to anyone under 21yrs of age) *
Your answer
All dogs-please list gender, age, breed, and if altered for each: *
Your answer
All cats-please list gender, age, breed, and if altered for each: *
Your answer
Any other pets in your household? If so, please describe: *
Your answer
Anyone in your household have allergies or asthma? *
If yes, who/what kind?
Your answer
Are you aware that dogs can shed all year long? *
Who will care for, train, and exercise your rescue dog? *
Your answer
What training methods will you be using? (ie obedience school, spray bottle, firm verbal commands, swat w/newspaper, remote collar, etc) *
Your answer
How will you exercise your rescue dog? *
Your answer
What housetraining method will you be using? *
Your answer
What will you do if you find your dog has urinated or defecated in the house? *
Your answer
Will the dog be allowed on furniture? *
Will your dog/s be allowed free run of the house? *
How many hours per day will your dog(s) be home without humans on a regular basis? *
Your answer
Where will the dog(s) be when you are not home? *
Your answer
Are you familiar with the use of a dog crate to train and/or confine the dog during your absence or at night? *
Are you familiar with the use of a dog crate to train and/or confine the dog during your absence or at night? (adult dogs should never be left for more than 6 hrs in a confined crate, puppies 3hrs) *
Are you planning to use a crate? *
If the dog is not housetrained, are you open to crate training? *
If no, please explain
Your answer
What will you do with your dog(s) if you need to be away from home overnight? *
Your answer
Will the rescue dog.....
be tied outside? *
live outside? *
be walked daily? *
be allowed to run free outside of a fenced yard? *
have annual vet checkups? *
receive formal obedience training? *
If you move, what will you do with your dog(s) and other pets? *
Your answer
If you were unable to keep this dog, would you return it to Helping Paws as required by our adoption contract? *
Are you aware of and do you understand the state/local ordinances concerning:
Dog licensing? *
Leashing/leash laws? *
Are you aware that costs of maintaining a dog can average $500-$1000 or more a year (food, annual check ups & shots, heartworm & flea/tick prevention, grooming, etc.); and may require expensive medical care for unexpected emergencies? *
Do you have Pet Medical Insurance? *
Please list any pets by name that you have owned, given away, or surrendered in the past, how old they were and ultimately what happened to them. (if they have passed away in the last 5 yrs please include their name & the year they passed) *
Your answer
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