Poofy Pals Rescue
Adoption/Foster Application
Email address *
Dog interested in?
First Name *
Your answer
Last Name *
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Primary Phone (Mobile) *
Your answer
Secondary Phone (Home)
Your answer
Email Address
Your answer
Do you keep your dog on a heartworm preventive? (Not flea drops actual heartworm prevention prescribed by a vet) *
Do you have pets now? *
List current pets, breeds, ages, and any health conditions.
Your answer
Why do you want a dog?
Your answer
Are you prepared to pay for emergency vet expenses if something happens to your pet? (emergency needs for pets can be in the thousands) *
List all members of your household with ages. *
Your answer
How many hours do you spend away from home each day?
Your answer
What is your employment status? *
Housing type? *
Vetrinarian's Name
Your answer
Vet's Phone Number *
Your answer
Date of last vaccines for your pet? *
Your answer
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