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Dog Adoption Application
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This form has been modified since it was saved. Please review all fields before submitting.
To apply to adopt a specific dog, please fill out this form.
Please note: We would like to help you find the right dog and understand its needs, so please fill in as much information as possible. While we carefully monitor all our animals, and make sure they receive necessary veterinary care, we have limited knowledge of their backgrounds. Therefore, we cannot guarantee the health, behavior, temperament, age, or breed of any animal adopted. Also, please understand that you assume full financial responsibility for this pet, including any health care or training.
Dog you are applying to adopt
Name
Email Address
Phone Number
Work Number
Address
City
County
State
Zip Code
How long at this address?
If less than 2 years, previous address
List all the animals you’ve owned in the last 5 years. Please include breed, name, sex, age, spayed or neutered, time owned, where pet is housed, do you still own the pet, if not what happened?
Do you have a veterinarian?
Yes
No
If yes, give his/her name, and clinic name and phone number
Briefly, explain why you’d like to adopt a dog
Number of People in your Home
Adults
Children
Ages of Children
Who will primarily care for this animal?
Do you live in a house or an apartment?
House
Apartment
Do you own or rent your home?
Own
Rent
N/A live in an apartment
If renting, please include the name and phone number of your landlord
Does any member of your family have allergies to animals?
Yes
No
Not sure
What percentage of time will the dog be outside?
0-20%
20-40%
40-60%
60-80%
80-100%
Do you understand it may take time for this pet to adapt to his new environment and new family members? (More than 1 week)
Yes
No
What will happen to this animal if you are to move?
Under what circumstances would you give up your pet?
Are you willing to take responsibility for this pet for the next 10 to 15 years?
Yes
No
Do you understand that you are legally and humanely responsible for this pet?
Yes
No
Will you seek behavioral/obedience training if necessary?
Yes
No
Are you willing to allow a City representative conduct a home visit prior to adoption?
Yes
No
Are you aware that there is an adoption fee?
Yes
No
Digital Signature
*
Date
Date
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