Adoption Application
This questionnaire has been designed to aid us in determining if the animal you're interested in will be a good fit for you and if your home is suitable for our rescue animal. Please answer all questions honestly and feel free to add your own comments.
Which pet are you interested in? *
Your answer
Today's Date:
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Full Name *
Your answer
Email Address *
Your answer
Daytime Phone *
Your answer
Evening Phone
Your answer
Best time to call:
Your answer
Home Address (street address, city, state, zip code): *
Your answer
Applicant's Age: *
Your answer
Marital Status:
# of adults in home:
Your answer
Please list all the other people in your home, their relationship to you, and their ages:
Your answer
If you no longer reside with any of these people, with whom would the dog remain?
Your answer
Occupation:
Your answer
Occupation of Spouse:
Your answer
Who will be primarily responsible for the care of the dog?
Your answer
Do you have children?
If yes, do they live with you?
What are their ages?
Your answer
Have they been around dogs before?
If you don't have children now, do you plan to have a family in the future? If yes, when?
Your answer
What are your reasons for adopting a dog?
Your answer
Would you consider adopting a dog with special needs? Check all that apply.
What qualities are you looking for in a dog?
Your answer
What breed(s) are you looking for?
Your answer
Are you familiar with the temperament of this breed? If yes, how so?
Your answer
Would you prefer male or female?
If you prefer specific colors or markings, please let us know which ones:
Your answer
Preferred age range?
Your answer
Do yo have any concerns about adopting?
Your answer
Do you consent to a home check in the event your application is accepted?
Type of dwelling:
Your answer
Do you rent or own?
Are pets allowed?
How many years have you lived here?
Your answer
Do you have a landlord and/or HOA?
If yes, may we contact them?
Please provide your landlord/HOA's name and phone number
Your answer
Where will the dog(s) stay during the day?
Your answer
If dog(s) stays inside, does he/she have access to the outside?
If the dog(s) stay outside, how many hours a day will they be left outside?
Your answer
What outside space is available for the dog(s)?
Your answer
What type of fenced yard do you have? Please also list height of the fence.
Your answer
Is there a grassy area? Is it fenced?
Do you have a pool?
What other access areas do you have for the dog(s)?
Your answer
Will the dog(s) be tied up?
Your answer
Are there areas where the dog(s) will not be allowed? Please list.
Your answer
Are you planning to move within the next 6 months?
If you ever had to move, would you dog come with you?
Have you had a dog in the past 10 years?
If so, when?
Your answer
Do you own a dog now?
Numbers of dogs in home?
Your answer
Do you have other animals in the home? Please list # of animals and where they are housed.
Your answer
Please list each dog separately, most recent first. Include the following for each dog: breed, sex, altered (yes/no), where you got the dog from, dog's age when acquired, if you still own the dog, what happened to the dog, and the dog's age at death
Your answer
Have your dogs been vaccinated?
Can you provide vaccination records?
Will you provide the necessary medical care?
If no, please explain.
Your answer
Veterinarian's Information (this reference must be provided to process application)
Your answer
May Animal Alliance of San Diego contact your veterinarian?
If no, please explain
Your answer
How many hours per day are the dog(s) left alone? Please explain
Your answer
Are there provisions to let dog(s) out during the day?
How many times are the dogs walked per day?
Your answer
How will your dog(s) spend the day?
Your answer
Do you have a friend or relative who could care for the dog(s) if you become incapable of caring for him for any extended period of time?
Will your dog(s) be allowed on the furniture?
Will you become frustrated if your dog(s) are not housebroken?
How do you plan to housebreak your dog?
Please understand that even dogs that are housebroken will go through an adjustment period.
Your answer
What would you do with your dog(s) if you could not keep it for any other reason not listed above?
Your answer
If your dog(s) needed acute medical attention for an illness or emergency care, are you prepared to handle the expenses?
If your dog(s) developed an illness and required monthly medication, up to what amount would you be comfortable spending?
Your answer
If you currently have a dog, what brand of food are you feeding him/her?
Your answer
If a higher quality food was recommended, but is more expensive, would you be willing to change foods? If no, please explain
Your answer
Have you ever trained a dog in obedience?
Your answer
Would you agree to take this dog to obedience school?
Your answer
If the dog becomes destructive, what would you do?
Your answer
When your dog disobeys, how do you reprimand?
Your answer
Would you ever use a newspaper or object to reprimand your dog to stop bad behavior?
What would you do if your dog started snapping or bit at you or a family member?
Your answer
Would you be able to live with fur on your furniture, stains on your rugs, a warm body on your bed who may be destructive at times?
What would happen to this dog if your family situation changed (divorce, relocation, death). Please answer in detail.
Your answer
Have you ever given away/sold or released an animal to a shelter or rescue group?
If yes, why?
Your answer
Have you ever been denied adoption by a shelter, other rescue group, or humane group?
If so, by whom?
Your answer
Do you travel a lot?
Where will dogs stay while traveling?
Your answer
How did you hear about this rescue?
Your answer
Briefly describe your lifestyle
Your answer
Adopters over the age of 70 years are required to have a co-adopter in case of accident or death. If this applies to you, who will be your co-adopter?
Your answer
Name/address of co-adopter and relationship to you:
Your answer
Please give 3 additional references. These may be friends, coworkers, relatives. Please include name, relationship and phone #)
Your answer
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