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Adoption Application
List the dog/dog(s) you are interested in adopting
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If you are interested in multiple dogs, click the "+" icon to add additional lines.
Name
(Required)
First
Last
Street Address
(Required)
Street Name
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
Best time to call
(Required)
Spouse or Roommate's name and telephone number
(Required)
How did you hear about us
(Required)
Facebook
Adopt-A-Pet
Adopted Here Before
Family/Friends
Other
Other info
Where do you live?
(Required)
In the city
In the country
On a farm
Do you own or rent?
(Required)
Own
Rent
Parent/Guardian/Landlord's name and telephone number (if applicable)
(Required)
Please tell us about each of your cats and/or dogs over the last five years, including current pets.
(Required)
Veterinarian's Name
(Required)
Veterinarian Mailing Address
(Required)
Veterinarian Phone Number
(Required)
Who will be the primary caretaker for the dog?
(Required)
How would you rate your dog experience
(Required)
First time owner
Beginner
Intermediate
Advanced
Why do you want to adopt a dog?
(Required)
Family pet
Gift
Guard dog
Child's pet
Hunting dog
Other
Is everyone in the house agreeable to getting a new pet?
(Required)
Yes
No
Are you willing to attend obedience classes at your own expense (prices range from $80 to $200)?
(Required)
Yes
No
Are there children living in your home? If so what are their ages?
Add
Remove
If you are interested in multiple dogs, click the "+" icon to add additional lines.
How many adults reside in the home?
Add
Remove
If you are interested in multiple dogs, click the "+" icon to add additional lines.
Does anyone in the home have allergies to pets? If yes, who, and how do you plan to deal with this?
(Required)
Is anyone in the home afraid of dogs?
(Required)
Where will your new pet spend the majority of his/her time?
(Required)
Inside house
Inside/outside equally
outside only
Where will your pet be kept during the day?
(Required)
Loose inside house
In a crate inside the house
In a fence in backyard
Is your yard fenced? how tall, what type of fencing?
(Required)
Is anyone at home during the day? when?
(Required)
Where will your new pet be kept at night?
(Required)
Where will your new pet be kept while you are on vacation, out of town or away from home for an extended period of days?
(Required)
How much do you plan to spend on a pet per year?
(Required)
Are you willing to make a lifetime commitment which could be 15-18 years for your pet, including medical care, grooming, proper diet, shelter, exercise, companionship, and love?
(Required)
What problems would make you give this pet up?
(Required)
barking
dog's health problems
moving
shedding
digging
illness in family
chewing
aggressive with other dogs
divorce
financial problems
poor watchdog
new job
growling at guests
kids mean to dog
biting
seperation anxiety
house training issues
allergic to dog
new spouse/partner doesn't like
dog not obedient enough
jumping on people
aggressive toward cats
new baby
dog grows too big
What would you do if you had to give this pet up?
(Required)
Give to family or freind
Puppy Protection
Take to nearest shelter
Sell it
Are you familiar with the use of a crate to train and/or confine a dog in your absence?
(Required)
Yes
No
Your ideal dog is (describe)
(Required)
What traits or behaviors would you have a hard time dealing with in a dog?
(Required)
drooling
odor
jumping on people
stubborn
shedding
nervous or shy
aggression
digging
plays too rough with children
dominance
escaping
not good with other pets
biting
submissive
destructive chewing
too energetic
noisey
overly protective
hard to housetrain
What traits or behaviors do you most like in a dog?
(Required)
independence
dependence
gentle
energetic
confident
playfulness
silliness
quiet
serious
protective
easy going
Some dogs are lively in the house. They like to play with you and follow you around. Do you think an active dog would annoy you?
(Required)
What is your prefered level of exercise with the dog?
(Required)
couch potato
yard exercise
short walks
vigorous walks
hiking and jogging
My new pet should get along with
(Required)
dogs
cats
ferrets
birds
farm animals
young children
older children
other
Other info
Please describe your dog training experience.
(Required)
What type of discipline will you use when training?
(Required)
Do all household members understand that it takes time for a pet to adjust to his or her new home?
(Required)
Select One
Yes
No
Are you willing to put up with some accidents while the dog adjusts to their new home?
(Required)
Select One
Yes
No
What kind of solutions would you be willing to try if housebreaking accidents continue after the first week?
(Required)
paper training/piddle pads
crate training
use of dog door
use of dog doorbells
consult a professional trainer
none
The noise level in my home is best described as:
(Required)
Select One
low
medium
high
Will your new pet be allowed on the furniture?
(Required)
Select One
Yes
No
Have you ever had behavior problems with previous dog(s)? What did you do to correct the issue?
(Required)
What made you decide to adopt this particular dog?
(Required)
In the last 6 months, has a dog or puppy died on your premises of distemper, parvo, or unknown causes?
(Required)
Select One
Yes
No
Would you object to our visiting your home prior to the adoption or as a follow up visit?
(Required)
Yes
No
Would you object to our verifying any of the information provided on your application?
(Required)
Yes
No
References(Need 3 to be considered) Non-Relative
References 1
Name
(Required)
Phone
(Required)
References 2
Name
(Required)
Phone
(Required)
References 3
Name
(Required)
Phone
(Required)
Name
This field is for validation purposes and should be left unchanged.
Training
Registration Form
In Home Training
Group Classes
Testimonials
Testimonials – Greenville
Palm Beach
Our Trainer
About Nancy
Philosophy
Puppy Protection
About
Get Ready!
Breed All About It!
Foster Friends
Happy Tails
Forms
Adoption Application
Foster Application
Surrender your pet
Pawsitive Info
Doggie Demos
Health
Natural Remedies