Who would you like to adopt?
Adopter Information
Adopter's Name:
Email:
Address:
Phone Numbers:
Please provide at least
one .
—Please choose an option— Home Mobile —Please choose an option— Home Mobile Work —Please choose an option— Home Mobile Work Will there be a Co-Adopter?
Yes No Co-Adopter's Name:
Co-Adopter's Email:
Ages of all permanent residents of your home (adults/children):
Do you currently have any pets at home?
Yes No Personal References
Please provide
two people who know you, but are
not related to you. Your pet sitter, doggie daycare contact, you volunteer at a shelter or rescue, etc.
Nature of Relationship
Reference #2:
Nature of Relationship
Are you planning to move in the near future?
Yes No If moving soon, to what city/state?
When will you be ready to adopt this dog/cat?
—Please choose an option— Today! This weekend Within one week Within one month As soon as I am able Are you in contact with any other rescues or shelters about a specific dog or cat?
Yes No Name and address of shelter(s):
How far along in the process are you?
Email Inquiry Only Appointment Set Application Submitted
Is anyone in your home allergic to dogs or cats?
Dogs Cats Dogs and Cats Neither Not sure Does anyone in your home fear dogs and/or cats?
Dogs Cats Dogs and Cats Neither Does anyone in your home smoke?
Yes No Are you familiar with pet regulations in your area?
Yes No Please describe local pet regulations and restrictions:
What type of dwelling is your home?
—Please choose an option— Live in a Single Family Home Duplex/Twin Condo/Townhouse Trailer Apartment Do you own or rent this property?
Own Rent Have you contacted your landlord to find out if there are any restrictions on the kind or size of dog you can have or the number of dogs or cats?
—Please choose an option— Yes. Not yet, but I will. It's written in our lease
Approximate square footage of your home?
—Please choose an option— Less than 800 square feet 800-1,000 square feet 1,000-1,500 square feet 1,500-2,000 square feet Over 2,000 square feet Do you have a yard?
Yes No If you have a yard, check which applies:
—Please choose an option— Fenced with a vertical fence Fenced with invisible fencing No fence
What is your fence height?
Is there a pool at your home?
Yes No Is it in-ground?
Yes No
Where do you work from?
—Please choose an option— Outside the Home Home Office Retired If you work outside the home, how many hours per day are you away?
Will there typically be at least one Adopter home for all or part of the day?
Yes No
How many hours per day will this pet be alone?
Please explain.
Have you discussed this adoption with all members of your household?
Yes No Who is going to be responsible for the care and feeding of the pet?
Based on the description in the pet’s bio, do you feel confident that you will be likely to adopt this pet upon meeting it?
Yes No How much do you feel you can reasonably afford and would be willing to spend on your pet per year (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)?
$
/year
What activity/energy level do you prefer?
—Please choose an option— Low Medium High No Preference Check all that apply:
Wild and crazy is cool Leash trained daily jogging partner would be excellent Plays then hangs out with you Walks slowly on leash, a total couch potato I want to adopt this animal...
Please check all that apply.
As a family pet To train/use as a therapy animal For a jogging/hiking partner To interact with lots of friends/family As a companion for my dog(s) As a companion for my cat(s) As a companion for my child/children My adopted pet will...
Please check all that apply.
Be kept outside most of the time Be kept outside all of the time Be kept indoors most of the time Be kept indoors all the time Be left outside during the work day while we are away Be kept inside while we are away Be confined or crated when we are not home Have free reign of the house when we are not home Be taken to formal obedience classes Be trained Take frequent car rides Be kept on a lead line/cable in the yard Be mostly interacting with adults Be interacting frequently with children under 8 Be interacting frequently with older children Must be housebroken prior to adoption Will be housetrained upon arrival Will be walked more than one mile per day every day Will be walked occasionally Be attending formal group obedience classes Be trained without the advice of a trainer Have private sessions with a trainer as needed Be attending agility classes Be boarded when we go on vacation Stay with family when we go on vacation Be going camping Be going on boat trips Please take time to think, be honest with yourself when answering this question.
What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the pet?
Housebreaking Chewing Scratching furniture Jumping Pulling on leash during walk Obedience training Fear of men Fear of women Fear of children Mouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training) Growling Barking (dogs) meowing (cats) Rough play with my other pets High activity level Food/toy aggression/not willing to share with other pets Food/toy aggression with people Whining/crying Counter surfing Blindness Limited Sight Deafness Separation Anxiety Diabetes Special Diet Long Term Medication Incontinence / Leaking Urine Taking classes with the dog Gets stressed/carsick when riding in vehicle Doesn't know how to climb stairs Can't climb stairs due to age/arthritis/health issues Heart condition Skin allergies Food allergies Trimming nails Yeast on coat or in ears Ear mites Fleas Ticks Heartworm preventative Annual heartworm/lyme combo testing I will do whatever it takes to help this pet adjust and work with a trainer if necessary to help resolve any training needs What would cause you to return a pet?
What do you feel is a reasonable amount of time for a pet to adjust to life at your house?
Days Months Years How do you plan to integrate this pet into your family?
What would you do if you discovered after adoption (at any time during the life of the pet) if your vet diagnosed an expensive health condition?
What pet food do you plan to feed them?
Do you have a coat preference with regard to shedding?
Yes No Select all that apply.
Hairless (No Shedding) Wire-Haired (Light Shedding) Long-Haired (Heavy Shedding)
What is your grooming plan?
Use a Professional Groomer Bathe at Home (Dogs) Please select bathing frequency:
—Please choose an option— Once a Week Once a Month Every Few Months Whenever Their Coat Feels Dirty Twice a Year Almost Never
Other Care:
Please check all items that you are willing to provide for your new pet.
Trim Nails Check ears for infection/yeast/mites Check coat for ticks in spring/summer/fall Clean teeth using home methods Take pet to the vet for dentals whenever the vet recommends this is needed How long have you been looking for a pet?
Days Months Years Do you plan to take formal obedience classes?
Yes No Do you have any additional comments, questions or concerns?
Yes No Anything else you would like us to know to help match you up to a dog or cat?
Yes No
Adopter's Signature
Today's Date
By checking this box, I agree that all information provided is true and factual, and any misrepresentation may result in the rejection of my adoption application. 
