Dog Application
Fields marked with an * are required

The goal of Bedford Humane Society is to find accepting, permanent homes for the dogs we rescue. The information on this form will help us to be certain that we are placing the right dog with right family to best fit the dog’s personality and to meet the family’s expectations.

Bedford Humane Society reserves the right to refuse adoption to anyone at any time.

If the animal you are applying for is not old enough to be spayed or neutered, that animal is not available for adoption outside of the counties contiguous to Bedford County.

Please complete this application in full to prevent delayed processing. Incomplete application will be returned to the applicant.

Adoption fees will vary depending on age, breed, health and other factors.
Sign in to Google to save your progress. Learn more
Email *
Animal Name  *
Confirm Email *
First and Last Name *
Date *
MM
/
DD
/
YYYY
Full Address *
Phone Number *
Preferred method of contact
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy