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Adoption Form
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Email
*
Your email
Option 1
Clear selection
Which dog are you inquiring about?
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Your answer
How did you hear about this dog?
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Your answer
Full Name (First and Last)
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Your answer
Address (Street, City, Zip Code)
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Your answer
Cell Phone
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Your answer
FL Driver's License # or Valid I.D. #
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Your answer
Occupation
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Your answer
Employer
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Your answer
Employer Address
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Your answer
Employer Phone
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Your answer
Are you adopting this pet for yourself or someone else?
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Me
Someone else
Type of Housing
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Single Family Home
Apartment/Condo
Duplex
Mobile Home
Do you own or rent?
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Own
Rent
If renting, please provide landlord's name and number so we can verify the ability to adopt
Your answer
Does your landlord allow pets?
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Yes
No
N/A
Do you have a fenced in yard?
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Yes
No
Do you have a pool?
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Yes
No
Do you plan on moving in the next 6 months?
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Yes
No
If you move in the next 6 months, what will you do with your pets?
Your answer
Do you have young children?
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Yes
No
If you have young children, how much time do you have for a dog?
Your answer
What do you do with your pet while you are at work?
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Your answer
Where will the dog stay during the day?
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Your answer
Do you have other pets currently?
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Yes
No
Please list all pets in the home (including small pets), ages, and temperament.
Your answer
Are your pets spayed or neutered?
Yes
No
Clear selection
How much is your limit for vet bills throughout the dog's life?
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Your answer
Will you provide training for the dog if required?
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Yes
No
Maybe
Please list contact info for current veterinarian, if applicable.
Your answer
Have you ever turned an animal into a shelter or given your animal to someone else?
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Yes
No
Have you ever put your animal to sleep for any reason?
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Yes
No
If you answered yes to either of the above questions, please explain
Your answer
Are all the members of your household in agreement about adopting a dog?
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Yes
No
I haven't told them yet
Please list all the people in your home, including ages.
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Your answer
Does anyone have any allergies/asthma?
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Your answer
What member of the family will be taking the MAJOR responsibility of caring for this pet?
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Your answer
How long will you give your new dog to adjust to its new home?
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Your answer
What will you do if your dog doesn’t get along with your current animals?
Your answer
If your family status changed (new baby, married, divorced, job loss, relocation) Who would keep the dog?
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Your answer
If something happens to you (sickness, death, etc. ) and you cannot take care of your pet(s), Who will take care of them?
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Your answer
When you go on vacation, where will your pet(s) go, and who will take care of them?
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Your answer
Please supply the name, address, and phone number of two personal references
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Your answer
Any other additional information you feel is important?
Your answer
I certify that the information I have given above is true and correct, and I hereby authorize the above listed Veterinarian(s) to supply information in regard to my I also give my permission to contact the above listed landlord and references.
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I agree
Required
Applicant Signature
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Your answer
Application Date
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Your answer
A copy of your responses will be emailed to the address you provided.
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