Adoption Application
Date
MM
/
DD
/
YYYY
Name of the Dog you are interested in *
Where did you hear about the dog
Name *
Address
City
State
Zip Code
Phone Number
Email Address
Preferred Contact Method
I am 21 years of age or older *
Required
Housing Information
Do you rent or own *
Required
If renting, what is the policy on allowing pets
Is there a deposit fee for pets
Is there a weight or breed restriction for pets
May we contact your landlord
Landlord’s Name
Landlord’s Phone No.
Do you have a fenced in yard
If yes, what type and how high
Do you have children in your home
If yes, how many and the age of each child
Do your children understand the responsibilities of caring for animals
Current/Past Pet Information
Do you currently own any pets
If no, have you owned any pets in the last four year
Please list the name, breed and age of your current or pets in the last 4 years
Are the vaccinations current for your pets
Date of Expiration
Are your pets on heartworm preventative
Name of the preventative
Are your pets spayed/neutered
If no, please explain why
May we contact your Veterinarian
Veterinarian Name
Veterinarian’s Phone Number
New Pet Information
Do you understand the history of the dog you are adopting
How much time will the dog spend alone
How many hours per day will the dog be alone
When no one is home, where will you keep the dog
Where will the dog sleep at night
Are you prepared to spend from 150.00 to 300.00 per year in veterinary fees for routine shots and preventative medicines, such as frontline, heartguard, etc.
How much time are you and your family prepared to spend with the adopted dog
In case you experience a life change, such as a move, a divorce or a new baby, how will this affect the adopted animal
Do you understand that adopting a pet is a commitment for the animal's entire lifetime and are you willing to accept that responsibility
May we visit your home
Personal References
First Reference *
First Reference Phone Number *
Second Reference *
Second Reference Phone Number *
Do you agree to the above terms *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.