Rescue Outreach Dog and Puppy Adoption Application
Please complete this form in it's entirety. If you choose not to answer pertinent questions, we will proceed to the next applicant and you will be asked to re-submit the application. In order to meet an adoptable dog or puppy, you must have completed the adoption application process.

Please note that we are based out of Southeastern Wisconsin. All adopters will be expected to travel to the foster's home if asked. Please also note that local adopters will be considered first. This is simply so we can easily be of assistance in the transition process of welcoming your new dog or puppy into your home.

Thank you for understanding, and thank you for considering adoption with Rescue Outreach. Because of people like you, we can save animals like them...

IF A QUESTION IS NOT APPLICABLE TO YOUR SITUATION, PLEASE TYPE "NOT APPLICABLE"

Name of dog/puppie(s) you are interested in adoption. *
Your answer
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
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/
DD
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YYYY
Telephone Number with Area Code *
Your answer
Email Address *
Your answer
Street Address *
This is your house number and Apartment/Unit number where applicable
Your answer
City *
Your answer
State and Zip Code *
Your answer
Do you OWN or RENT your residence? *
Landlord's Name *
Your answer
Landlord's Telephone Number *
Your answer
What is your profession? *
Your answer
What are your work hours? *
Your answer
List the name(s) of other cats in the home. *
Your answer
List the name(s) of dogs in the home. *
Your answer
Are your other animal(s) spayed or neutered? *
Your answer
Have you ever surrendered or re-homed an animal? Please explain. *
Your answer
What brand(s) of food do you feed your animals? *
Your answer
Have you ever owned a dog? *
Are you aware that puppies require de-worming on a schedule when young until advised to stop by a licensed veterinarian? *
Do you plan to complete the vaccination schedule for your dog/puppy? *
Does anyone in the household have an allergy to animals? *
What will you do to help your new dog/puppy adjust to your home? *
Your answer
It may take several weeks to a few months for your new animal to adjust to its new home and family. How will you handle this? *
Your answer
What would be a situation in which you would no longer be able to keep your dog/puppy? *
Your answer
What would you do with your dog/puppy if you could no longer keep it? *
Your answer
Co-Adopter First Name *
Your answer
Co-Adopter Last Name *
Your answer
Co-Adopter's Profession *
Your answer
Co-Adopter's Telephone Number *
Your answer
Co-Adopter's E-mail Address *
Your answer
How many children live in the home? *
Please list the ages of ALL children that live in OR visit the home regularly. *
Your answer
Does anyone adopting have a prior conviction of felony? *
Do you agree to allowing Rescue Outreach, Inc. perform a background check? *
What is your Veterinarian's Name and Phone Number? *
Please note that we will be contact your vet. Please list all offices that have treated your animal(s) in the past 2 years.
Your answer
Are your current pets up to date on their vaccinations? *
Describe your ideal dog/puppy and why you want to adopt. *
Your answer
Where will your dog/puppy live? *
Do you have a fenced in yard? If so- HOW TALL and WHAT MATERIAL is it made of? *
Your answer
How do you plan to exercise your dog/puppy? *
Your answer
Are you willing to keep your pet leashed when not in a properly enclosed area, at least until properly off leash trained? *
Have you done any research on socializing a dog? How will you do this? *
Your answer
How is heartworm transmitted? *
Your answer
Do you plan to administer monthly preventive medications to your dog? *
Do you believe in obedience training? *
Will you crate train your dog? *
Where will your dog or puppy stay when you are not home? *
Your answer
How many hours will your dog/puppy be left alone in a day? *
Your answer
If your dog or puppy has an accident in the house, how will you correct the behavior? *
Your answer
Is there a member of your household that does NOT want a new dog/puppy? *
How did you hear about Rescue Outreach? *
Required
Please type your full name below if you acknowledge all provided information to be true. *
Your answer
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