Dog Adoption Request Form

Pet name:

Foster's email:*

For faster processing, provide the foster's email from the PetFinder or Adopt-a-Pet biography.

First name:*

Primary phone:*

Last name:*

Cell phone:

Email:*

Employer:

Home address:*

State:*

County:

Ownership:*
RentOwn

Yard:*
YesNo

City:*

Zip code:*

Years at this address:*

Home type:*
HouseApartmentCondoMobile home

Are you over 18 years old?*
YesNo

Do you live with your parents or other relatives?*
YesNo

Dog is for:*
YouFamilySomeone else

Anyone in the family allergic to animals:*
YesNoNot sure

Why do you want a dog?
Companion for self/familyCompanion for other petsGift for family memberWatch dog/protectionHuntingYard dog

Are you active military?*
YesNo

Is everyone in the family in favor of adopting a dog?*
EveryoneNot everyoneNot sure

Are there children in your home?
YesNo

Do you have pets living with you?*
YesNo

Do you object to spaying and neutering pets?*
YesNo

Have you ever taken a pet to a shelter?*
YesNo

Sex:*
FemaleMaleNo preference

Age:

Breed:

Potty trained:*
Yes, must be trainedOptional, willing to train

Obedience trained:*
Yes, must be obedientOptional, willing to train

Adult size:
Small (up to 20 pounds)Medium (20-50 pounds)Large (50-80 pounds)XL (Over 80 pounds)

You understand dogs will have an adjustment period in their new home:*
YesNo

(changing a dog’s environment can cause them to have accidents in the home)

When no fenced yard is available, are you able and willing to walk your dog on a leash three or more times daily?*
YesNo

If you became ill, is there someone who would assist with petcare?*
YesNo

Estimated costs for annual preventive care:

Where will this dog stay?

% inside

% outside

Where will the dog stay while unattended?

Typically, for how many hours will the dog be left unattended?

Have you ever raised a dog from a puppy?
YesNo

Do all the adults in the house work full-time?
YesNo

Puppy proofing your home:
YesNo

(secure wires, lock up hazardous materials and chemicals, etc.)

Leash training:
YesNo

Do you understand teething puppies chew all sorts of things?
YesNo

(puppies teeth for several months as they lose their baby teeth and adult teeth come in)

Potty training:
YesNo

(it may take several months for a puppy to be fully potty trained)

Will you crate train?
YesNo

Vet's name:

Vet phone:

Vet city/state:

Reference name:*

Reference phone number:*

Reference address:

City:

State:
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWisconsinWyoming

Postal code: