Dog / Puppy Adoption Application

Adoption Application

Name of the dog you are interested in:

Your Name

First Name

Last Name

Email

Phone Number

Address

Street Address

City

State / Province

ZIP / Postal Code

Occupation

Housing and Residence

Select the option that best describes your current home or primary residence:

House Apartment Condominium Other

If another type of residence, please explain:

Select the option that best describes your residency:

Own Rent

Do you have permission from your landlord to have a dog/puppy live on the property?

Yes No

Landlord's Name:

Landlord's Phone #:

How many members are in your household (including yourself)?

Are there any babies, toddlers, or young children living in your household?

Yes No

What are their ages?

Does every member of your household agree to the adoption of this pet?

Yes No

Is any member of your household allergic to pets or animals?

Yes No

If allergic, please explain:

Environment for the Dog

Please select the type of living situation you plan for this dog:

Indoor Outdoor Indoor and Outdoor

Is the dog allowed on the furniture?

Yes No

Where will your dog sleep (be specific)?

Do you have a dog door at your residence?

Yes No

Do you have a private fenced yard?

Yes No

What percentage of the time will the dog be in the yard?

Do you share your yard with anyone else?

Yes No

Please describe the type of fencing surrounding your yard:

How high is your fence (at its lowest point)?

If you have a gate to enter/exit your yard, how high is it?

Are you certain your yard and fencing are secure enough for a dog?

Yes No

Do you have a swimming pool on your property?

Yes No

Is the pool secure and gated?

Yes No

Employment and Daily Routine

Please choose the option that best describes your employment status:

When you are at work, where will the dog be?

Will anyone in your household be home when you are at work?

Yes No

At the moment, is anyone at your home during the day?

Yes No

When you go on vacation or a trip, who will care for your dog? (select all that apply)

A family member A friend or neighbor A pet sitter A boarding kennel Other

If another type of care, please explain:

Do you currently have any other pets/animals living in your household?

Yes No

What kind of pets/animals?

Dog Cat Bird Other

If another type of animal, please explain:

Please describe the other dog(s) that live in your household:

Is the other dog(s) in your household spayed or neutered?

Yes No

Please explain why the other dog(s) are not spayed or neutered:

Have you ever had a dog before?

Yes No

How many years of experience do you have as a dog owner?

Have you ever had a dog (or another beloved pet) pass away before?

Yes No

What happened to him/her?

Under what circumstances would you consider giving up/surrendering your dog (check all that apply)?

If another circumstance, please explain:

If your dog were to develop behavior issues (i.e., nipping, biting, barking, digging), will you be willing to consult a trainer before giving the dog up?

Yes No

If you are not willing to consult with a trainer, please explain why not:

Pet History

Have you ever been responsible for losing a dog (or another pet) before?

Yes No

How did you lose that pet?

If your dog gets out, which of the following will you do (check all that apply)?

Search the neighborhood Contact animal control Post on social media Contact a shelter Other

In the past, have you ever been forced to give up your dog (or another pet) before?

Yes No

What was the surrender process?

Shelter Gave to a family member or friend Rehomed online Other

If another type of surrender, please explain:

What will you do if/when your dog gets sick or injured?

Do you know how much veterinary care typically costs?

Yes No

Are you prepared to spend the money for proper care of your dog, if needed?

Yes No

If you have cost limitations, please explain:

Do you currently have a trusted veterinarian?

Yes No

Name and phone number of your veterinarian:

Training and Commitment

What will you do if/when your dog/puppy misbehaves (e.g. chews your favorite shoes or furniture)?

How will you get your dog/puppy to do what you want him or her to do?

Have you ever trained a dog/puppy in an obedience class?

Yes No

Do you still use those same training methods?

Yes No

Do you think it is necessary for your dog to wear an ID tag?

Yes No

A pet requires a lot of attention. Are you prepared to spend a lot of time with your new pet (for the rest of its life)?

Yes No

Are you prepared to make a commitment to provide love and care for this new pet (up to 15+ years, if time permits)?

Yes No

By checking the following boxes, I am agreeing to the following statements:

I agree

Initials here:

Today's Date:

Dog / Puppy Adoption Application

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