Name *
Home Phone
Home Phone
Work Phone
Work Phone
Cell Phone *
Cell Phone
Address *
(House, Condo, Apartment, Townhome, Duplex)
Are you expecting to have children (or more) children in the future? *
If so, what age(s)?
If yes, please explain.
Please be specific on number of hours.
Please be specific.
(chewing, digging, etc.)
Are you familiar with your local leash/licensing laws? *
Please keep in mind that emergency costs can quickly escalate into thousands of dollars in some cases. For example, if your dog eats a toy which causes an obstruction, emergency surgery could easily cost over $1,000.
(marriage, new baby, divorce, behavior issues, financial stress, moving, job change, etc)
It is our policy to conduct a home visit prior to finalizing the adoption. Is this acceptable to you? *
We like to keep track of the dog via updates and communication post-adoption. Is this acceptable to you? *
You may also use this area to describe the type of dog you are looking for.
If applicable, is your landlord aware that you are planning to adopt this particular breed of dog?
Please select age preference:
(dominant, submissive, shy, confident, aggressive, protective, loving, active, calm, intelligent, playful, independent)
Please include age at passing, cause of death, or why rehomed.
Veterinary References
Do we have your permission to speak with your veterinary references?
Personal References - NON FAMILY MEMBERS:
Reference 1. *
Reference 1.
Phone *
Reference 2. *
Reference 2.
Phone *
please list a personal reference that is a family member
Phone *