VIVA Dog Adoption Form
We request that you fill out this form in order to assist us in serving you and to assure a successful adoption. Thank you for helping us help you.

In order to be considered for an adoption, you must be at least 18 years of age, present legal identification, and be able to verify that you can have a pet where you live.
NAME:
SPOUSE / PARTNERS’ NAME:
ADDRESS:
EMAIL ADRESS:
HOME PHONE:
MOBILE PHONE:
DRIVER’S LICENSE NUMBER:
DRIVER'S LICENSE STATE:
DRIVER'S LICENSE EXPIRATION DATE:
DO YOU OWN OR RENT?
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WHAT KIND OF HOME?
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LANDLORD'S NAME AND CONTACT INFO (if applicable):
EMPLOYMENT STATUS
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OTHER ADULTS IN HOUSEHOLD
CHILDREN IN HOUSEHOLD?
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NAME OF DOG INTERESTED IN ADOPTING
You have chosen a new animal friend. Have you considered the cost of food, regular veterinary care, and extraordinary care that may be required if your dog becomes ill? Are you prepared to assume this financial responsibility?
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On average, how often are you or another adult at home during the day?
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Remember that you are taking on a long-term commitment that may last over twenty years. Please indicate your plans for your animal companion(s) when you move.
When you go on vacation, what will you do about taking care of your dog(s)?
Do you have a fenced yard?
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How high is your fence?
Any gaps at the bottom where a small dog could squeeze out?
All dogs benefit from being indoor animals, but some dogs MUST be kept indoors. If your dog is to be indoor/outdoor, will it always be inside at night?
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How will it have access to your home when you are not home or away?
What is the name of your veterinarian or clinic? (Please list the city they are located in.)
What other animals are there in the home? Ages? Breeds?
If yes, are they all spayed and neutered?
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If cats, have they been de-clawed?
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Does anyone in your household have allergies?
What will you do to provide a healthy, safe alternative if allergies present a problem?
If you do not have a dog in your household at this time, have you ever had a dog?
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List the pets you have or have had in the past and tell us what happened to those pets.
When you introduce your new dog to your household, it may take time and patience until it is comfortable. Are you willing to give your new pet at least a month to settle into its new home?
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