Work Phone and Extension
Which describes your housing situation *
- I own.
- I rent and have spoke with the landlord about their pet policy.
- I rent but do not know the landlord's pet policy.
Name of Pet You Are Interested in Adopting *
Will this be your first pet? * Are you adopting this dog primarily for protection? *
Why do you want to adopt a dog? *
Is the dog to be a companion for a child or handicapped or an elderly person? If so, please explain. *
How many children live in your household?
If you have children, please list their ages.
If you do not have children in your household, please put N/A.
Why do you feel this particular dog is right for your home?
Do you have any specific questions or concerns about this particular dog?
If the dog you are applying to adopt will be your first pet, please describe what (if any) experience you have had with pets (friends, family members, etc.).
The vet bills for a dog have the potential to cost hundreds of dollars, particularly in the event of an emergency. Are you prepared to finance that kind of situation? *
List all the pets that have lived with you in the past 10 years:Please provide age, sex, breed, and whether they had been spayed or neutered.
Are they still living with you and if not, what became of them?
Please list the name and phone number for all veterinary clinic(s) that have seen your current and past pets as well as any other pets in the household. *Please note where the pets might be listed under a different name. i.e. your spouse's or roommate's. Please also include the name of the pets.
Have you ever had an animal put to sleep for any reason other than injury or illness? If yes, please explain. *
Do you have a fully fenced in yard?If you do not have a fully fenced yard, this may be a factor we consider
for adoptions of some dogs but it will not disqualify you from being
considered to adopt any of our dogs. * Is everyone in the family aware of the application to adopt this animal? * Will the dog interact with any children? * Will you be practicing crate training in your home? * Have you ever house-trained a dog or cat? *
What other animals will the adopted dog live with? If not the applicant, who are they owned by?Please provide species, breed, sex, and age information.
Where will the dog sleep? *
Where will the dog eat? *
Will the pet be primarily indoor or outdoor? Explain. *
It may take several weeks for your adopted dog to adjust to your home, how much time are you willing to allow for the adjustment period? *
- 1-2 Weeks
- 3-4 Weeks
- 5-6 Weeks
- 7-8 Weeks
What kind/brand of food do you plan on feeding your pet? *
What kind of feeding schedule will the dog be on? *
What monthly heartworm prevention product will you use? *Provide brand name or answer none if you do not plan to use one.
What monthly flea/tick prevention product will you use?*
Provide brand name or answer none if you do not plan to use one.
How many hours per day do you anticipate the dog being left alone? Where? Please explain. *
How will the dog receive his exercise? *
What will happen to the dog if you move? *
- I will take them with me.
- I will have to find the dog a new home.
How about future plans for children, stepchildren, or grandchildren?
Are there any circumstances in which you would return this dog? If so, what are they?
Do you have questions about dog training or behavior?
Is there anything else you'd like to mention to us?
Do you agree that if your application is approved, and the adoption does not work out, for whatever reason, days after the adoption, or years after adoption, you will return the dog(s) back to RCHS? *This stipulation is also referred to in the adoption application you are required to sign.