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Adoption Application

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Adoption Application

Adoption Application

Name or Type of dog that you're interested in adopting*
Personal Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Main Phone #
Alternate Phone #
Occupation*
Spouse/Partner Occupation
Your Age*
How many adults live in your home?*
Who will be the primary caregiver?*
How many children live in your home?*
What are their ages?
Do you or anyone else in your household have pet allergies?*
- Yes
- No
Veterinarian's name and number:*
Do we have permission to check past vet records?
Your Home
Which do you live in?*
- House
- Apartment
- Townhouse
- Condo
- Mobile home
Do you own or rent?*
- Own
- Rent
If you rent, do you have your landlord's permission to own a dog?
- Yes
- No
If yes, we would also want to contact the owner to get confirmation.
Are there any breed or weight restrictions?
- Yes
- No
Please explain the breed or weight restrictions at your rental property
Do you have a yard?*
- Yes
- No
Is the yard totally enclosed?
- Yes
- No
What is the lowest height of your fence?
Is the fence/gate kept locked?
- Yes
- No
Have you recently checked the entire perimeter of the fence to ensure that a dog cannot escape?
- Yes
- No
LOOK FOR SOFT DIRT TO DIG UNDER, BARS SPACED TOO FAR APART, etc
Do you have a pool?*
- Yes
- No
Is the pool fenced?
- Yes
- No
Do you have a doggie door?*
- Yes
- No
Can you ensure that your gardener, housekeeper, etc will not let the dog out of the yard?*
- Yes
- No
Future Dog and Pet History
Do you have any other pets?*
- Yes
- No
Please list their breed and age
Do they live inside or outside?
- Inside
- Outside
Are they up to date on their vaccinations?
- Yes
- No
Are your pets neutered/spayed?
- Yes
- No
Are they dog socialized?
Have you ever introduced a new dog into your home? If yes, how did it go?
Do you walk your dogs? If yes, then where?
If you were to see a Coyote on your walk what would you do?*
Which of the following are true?*
- I have never seen a coyote, I'm not worried,
- Coyotes come out during the day
- Coyotes can jump over an 8ft. fence
- Coyotes will attack dogs even on leashes
- Coyotes are not afraid of humans
- All of the above
Check all that apply
If you drive a pick-up truck, would you allow your dog to ride in the back?*
- Yes
- No
Have you ever owned a pet before that you no longer have?*
- Yes
- No
Please list them all and explain what happened to each one*
Eg. Passed away, given away to family, taken to a shelter, ran away, etc.
Was your last dog obedience trained?
- Yes
- No
Have you ever turned your pet into a shelter?*
- Yes
- No
If yes, please explain.
Please enter a number from 0 to 24.
Why do you want to adopt this dog?*
- Companion for you
- Companion for children
- Playmate for other pets
- Guard dog/protection
- Therapy dog
- Gift
- Other (please explain)
Check all that apply
How many hours will the dog be left alone on a typical weekday?*
Please enter a number from 0 to 24.
Where will the dog be kept during the day?*
- Indoors (loose)
- Indoors (in one room)
- Laundry room
- Crated
- Balcony
- Tied up
- Yard
- Enclosed patio
- Dog-run
- Garage
Check all that apply
Will any place be off-limits for the dog when you are home? (i.e.- furniture, bedrooms, etc)*
Would this dog be left alone in the yard at any time? If yes, please explain.*
Where will the dog sleep at night? (please be specific - eg. garage, kitchen, etc)*
Brand and Type of food you will feed the dog?*
Which pet store will you purchase the food from?
What type of flea control will you use?
How will you care for your dog's teeth?*
How much are you willing to spend on medical bills for your dog?*
- up to $100
- up to $500
- up to $1000
- up to $5000
- whatever it takes
Check all that apply
If you did not answer "whatever it takes" - what would you do if the vet bills go over the amount you chose?
Under what circumstances would you consider giving up this dog?*
- Destructive chewing
- Barking
- Not housebroken
- Biting
- Too shy
- Shedding
- Separation anxiety
- Medical problems
- Not obedient enough
- Grows too big
- Too hyper
- Pets don’t get along
- Working too many hours
- Moving
- New baby
- Divorce
- Allergies
- Financial problems
- Personal health problems
- None of the above (I would not give up this dog)
Check all that apply
If you move will you take the dog with you? If no, please explain.*
What will you do if you move somewhere where dogs are not welcome?*
For what reason would you euthanize a dog?*
Do you think it's necessary for your dog to wear an ID tag?*
What provisions will you make for the dog if you should become unable to care for it?*
Who will take care of the dog when you travel?*
What methods will you use to train this dog?*
- Praise
- Verbal commands
- Clicker training
- Hit with newspaper
- Spanking
- Shock collar
- Hire a trainer
- Group classes
Check all that apply
What method will you use to potty train?*
When would the dog be off-leash outdoors?*
Will you use a choke chain? If yes, then when and why?*
May we conduct a home check prior to finalizing the adoption?*
- Yes
- No
Are you ABSOLUTELY SURE that you are ready to make this LONG TERM COMMITMENT?*
- Yes
- No
How did you hear about us?
Name
This field is for validation purposes and should be left unchanged.

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Contact Info

Phone number:
(818) 505-0006
Address:
4926 Vineland Ave. North Hollywood 91601

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