Dog Adoption Form Name of Dog Name * First Name Last Name Phone * Please add the best phone number to reach you at (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Who will be the primary care giver for this pet Where will the pet be kept when you are home Where will the pet be kept when you are not home If outdoors, please explain how your dog will be confined (i.e leash, zip line, chain, fence, ec.) This will not determine if you are accepted or not this is just to ensure your house if the best fit for the dog. If you plan on keeping your dog outside please indicate what type of shelter the dog will have Will the dog be home alone during the day? (i.e when you are at work) Yes No How many adults are in your household? Do you have any children and how old are they? Are there any regular visitor that the new dog must get along with? Please describe Does anyone in your home have allergies to dogs? Do you have any other animals? Yes No Please list all pets you currently have (species, age, sex) Are they spayed or neutered? Yes No Are they currently up to date on vaccinations? Yes No If you have cats, have they been specialized with dogs Yes No If you have dogs, have they been specialized with dogs Yes No Have you had pets in the past? What happened to them? Do you have a regular veterinarian? If yes, please provide name and phone number for vet referance How much do you estimate the veterinary cost to do annually for this pet? Do you live in a house, condo, apartment or other? Do you own or rent your home? If renting do you have your landlord permission to keep a pet? Yes No What will you do with this pet when you go on Holidays? What will you do with this pet if you need to move? Which of the following dog issues are you NOT willing to accept in your house (Check all that apply) Barking Digging Jumping Disobedience Sepreation Anxiety Property Danmage Shedding House Training Chewing Mouthing Under what circumstance would you relinquish this dog (Check all that apply) Moving Retirement Sick Dog New Baby Behaviroual Problems Allergies High Cost Of Animal Care Divorce/ New Relationship Have you ever rehomed a pet of relinquished to another rescue - please list why Are you willing to let a PAWS representative visits your home by appointment? Yes No Have you ever been charged with neglect or cruelty to animals? Yes No Have you ever house trained a puppy? Yes No How would you discipline a dog/puppy? Please explain. The adoption of a lifelong animal friend should not be implosive, but rather a carefully thought out decision which will ensure a loving, lasting relationship. Remembering that you are applying for a lifetime companion, are you willing to make an investment in both time and finances to care for and properly manage your new pet? Yes No Please list two non-relative references, preferably those who are familiar with both you and your pets. Please include name, phone number and relationship to your reference Thank you for submitting your application, one of our volunteers will be in contact with you as soon as possible!