Adoption Application for Dogs
Jewels Safe Haven Rescue Inc. Adoption Application For Dogs
Any Questions, Please Feel Free To Contact Us At:
Email: jshrescue@yahoo.com
Text: 631-353-2416
Call: 631-353-2416

Adoption Fees:

Puppies under 6 months - $650
Puppies 6 months to 1 year - $600
Dogs 1 to 2 years - $550
Dogs 2 to 5 years - $500
Dogs 5 to 7 years - $450
Dogs 7+ years - $400

Dogs come fixed, up to date on vaccines, microchips, dewormed, and have had training done (commands, confidence builders, crate training, etc.)
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Name of Dog you are applying for:
Full Name *
Today's Date *
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Email *
Date of Birth *
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Drivers License ID# *
Cell phone Number *
Full Home Address *
Are you planning to move within the next year? *
Do you plan on having children within the next couple of years? *
How long have you lived at your current address? *
Do you Own or Rent? *
Do you live in.... *
If rent does your lease allow pets? *
Landlords Name and Phone Number
(Put NA if you own)
 *
Please list names and ages of all adults and children living with you: *
Is this your first time owning a dog? *
What Animal Experience do you have? *
Have you ever surrendered a pet before? If yes, why? *
What is the reason you are looking to adopt? *
Do you have a preference for breed, sex, age, size, or hair length? If so, what do you prefer? *
Does anyone in your home have allergies to dogs? If yes, how severe? *
Please list names, age, sex, and breed of animals living in your home. (exclude fish or caged reptiles) *
Are all the animals spayed/neutered? If no, please explain why. (Please exclude rodents, birds, fish, or reptiles) *
Does your animals at home have any behavioral concerns? If yes, which ones?(Example: resource guarding, fearful) *
Will you provide that necessary training if needed? *
How many hours a day will the dog be left alone? *
Will you crate the dog? *
Do you have someone to take care of the dog if you are no longer able to? *
Do you have a fenced in backyard? If yes, how tall is it? Does it have any access points where the dog could get out? *
Who is your veterinarian? *
What is the name of your veterinarian's practice? What is their phone number? What is their address? *
Are you financially prepared to give your new pet yearly routine care and emergency medical care if needed? *
Please provide three references that we will contact before adopting the dog. Please provide their name, phone number, and relationship to you, please exclude household members.  *
Are you ready for a 12-15 year commitment to the amazing dog you are applying for? *
Signature and Date *
Submit
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