Adoption Application

Dog Adoption Application

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail

Phone Number

Area CodePhone Number

What is your occupation?

Family and Housing

# of adults in the family and their relationship to you

# of children and their ages

What type of home do you live in?

If you rent, what are the rules governing pets?

Tell us about yourself and your family? What type of home will the puppy have?

Does anyone in your family have a known allergy to dogs?

YesNO

Is everyone in agreement with the decision to adopt a dog?

YesNO

Tell us about how you will transition the puppy into your home. Include the plan you have to take care of a young puppy

Other Pets

What other pets do you have? Specify type and number.

How will you introduce your pets to the puppy? What will you do to foster adjustment?

Are these pets up to date on their vaccines?

YesNo

Are these pets spayed/neutered?

YesNo

If no to question above, why?

Have you ever had a pet euthanized? If so, why?

Have you ever lost a pet to an accident?

What is your plan to train your puppy? Describe your views on training-what techniques will you use?

Veterinarian

Do you have a regular veterinarian?

YesNo

Please provide contact information for your vet. By providing us with this information, you are allowing us to contact your vet.

If you do not have a vet already, have you started the research? We do require a puppy to be seen by your vet within a week of adopting.

About the pet you wish to adopt

Name of the dog you would like to adopt if there is a specific one you have seen or heard about.

What is your idea of an ideal dog?

Desired age

Desired size

Desired breed

Any breed you would not adopt?

Desired sex

MaleFemaleNo preferance

Would you be willing to adopt

Where will the dog spend the day? Describe.

Please describe sleeping arrangements at night for the puppy (a puppy will cry a lot during the night like a newborn baby.)

How many hours will the puppy stay alone during the day (the first few weeks and then the first few months.) Do not include time spent alone with another animal; a puppy must be supervised and cared for by you versus an older dog or cat.

Who will have financial responsibility for the puppy? (the average cost of a puppy is a few thousand dollars the first year-please keep in mind this is a 15 year commitment and just like a child unforeseeable expenses due occur.)

Do you agree to provide regular health care by a licensed veterinarian?

YesNo

Do you agree to keep the dog as an indoor dog?

YesNo

Do you agree to provide all the best medical care to insure your puppy’s health for his/her entire life (including if the pup develops an allergy, needs surgery or develops a chronic illness) If not please explain the circumstances that you would not select to treat your puppy.

When your puppy goes outside how do you plan to supervise it to make sure it is safe?

Do you agree to contact Unleashed if you ever chose to re-home the puppy? (knowing you would not have your adoption fee returned)

YesNo

All puppies need time to adjust to a new family and require housetraining and behavior training. Are you willing to provide any needed training (using professional training and/or puppy socialization classes)?

What behavior(s) are intolerable-things you absolutely cannot manage?

Do you agree to allow Unleashed to visit your home prior to adoption?

YesNo

Will you agree to allow Unleashed to stay in contact with you throughout the course of the dog’s life to receive updates and current photos?

How did you hear about Unleashed

Personal References

Please provide 3 names, addresses, phone numbers and emails of people who are familiar with you and your pets. Please do not use family members.

By checking yes, below, you certify that all of the information you have given is true and complete. This dog will reside in your home as a pet. You will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.

Do you certify the above?

YesNo

Thank you so much for your interest in adopting a dog from Unleashed. We will get back to you as soon as we have reviewed your application.

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