Dog Adoption Form

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

I have a veterinarian that my pet uses:

Name of veterinarian:

Do you rent or own?

Do you live with other adults?

Type of Residence:

Landlord's name / phone #:

Are pets allowed / restrictions?

What are the restrictions?

I have owned pets in the past five years?

List Pet's Name - Breed - Age - Were they sterilized? - Current on Shots- What happened to animal?

I am adopting this dog for?

Is anyone in the home allergic to pets?

How many adults in your home?

How many children (& their ages)?

Do all members of the family know that you plan to adopt a dog?

Where will your new dog live and sleep?

Describe?

Where will your pet be kept when you are not home?

My dog needs to get along with other:

Given the possibility of housebreaking difficulties, describe your expectations / method /for this task:

Would you be interested in signing up for Obedience Classes here at the shelter?

Bad dog habits that I can't tolerate:

Name of dog interested in adopting?

Date