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If you have a specific dog in mind enter it's name here:
Name
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Address
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How long have you lived at this address?
*
Main Phone
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Alternate Phone
Which are you interested in?
*
Adoption
Foster
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About Your Home
Are you permitted to keep pets at your home?
*
Yes
No
Not Sure
Do You Own or Rent?
*
Own
Rent
Landlord Name
*
First
Last
Landlord Phone
*
Landlord Email
Do you have a fenced in yard?
*
Yes
No
How tall is your fence?
3-4 Feet
4-6 Feet
6-10 Feet
Do you have a pool?
*
Yes
No
Is your pool fenced in?
Yes
No
Is a Pet Deposit Required at Your Residence?
*
Yes
No
Not Sure
Has Your Pet Deposit Been Paid?
Yes
No
Are there any restrictions as to the number of dogs and /or combination of dogs and cats that you may have at your residence?
Yes
No
Please provide details of the restrictions
Please let us know if any other people live at your address and list their ages.
*
Do you or anyone in the home have pet allergies?
*
Yes
No
Please provide details of the allergies.
Do you currently have any other pets?
Yes
No
Please provide details on your other pets including age and breed.
Are all the pets spayed and or neutered?
Yes
No
Not Sure
Are these pets current on all vaccinations and on heartworm preventative?
Yes
No
Not Sure
Veteterinarian Info
Do you currently have a Veterinarian?
*
Yes
No
Have you had a veterinarian in the past?
Yes
No
if you have no history with a vet, please indicate here how to locate past animals health records
Veterinarian Name
First
Last
Please provide the name of your Veterinarian.
Veterinarian Phone
Please provide the number to your veterinarian
About Your Schedule
Are you currently Employed?
*
Yes
No
Who is your employer?
Are you a frequent traveler?
*
Yes
No
Is someone home during the day?
*
Yes
No
Who will watch your pets when you are away?
*
Where will the dog spend its time during the day?
*
Approximately how long will dog be alone each day?
*
0-4 Hours
4-8 Hours
8-12 Hours
How many years experience do you have with Dogs?
*
Please enter a number
Have you ever been bitten or attacked by a dog?
*
Yes
No
Please provide brief detail how you were bitten/attacked
Are you comfortable approaching dogs that you don't know?
*
Yes
No
Not Sure
Are you willing to assume the risks involved with animals who are sometimes frightened when in unfamiliar surroundings and may become aggressive?
*
Yes
No
References
Personal Reference Name
*
First
Last
Personal Reference Phone
*
What is your relationship to this person?
Business / Work Reference - Name
*
First
Last
Business / Work Reference - Phone
*
How are you associated with this person?
*
Reference Three of your choice
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First
Last
Reference Three Phone
*
What is your relationship?
*
How Did You Hear About Us?
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