Rescue Rehab Home
Adoption Application
1.
I am applying for the dog named:
2.
Date:
Please answer all questions completely. Please know that we are not trying to be intrusive but simply are doing everything possible to find the best match for each pet and family. Thank you for understanding.
3.
First Name:
4.
Last Name:
5.
Age?
6.
Email:
7.
Phone:
8.
Mobile:
9.
Address:
10.
City:
11.
State:
12.
Zip Code:
13.
Driver's License No.:
14.
State:
15.
Occupation:
16.
How long have you resided at this address?
17.
How long have you been looking for a dog?
18.
Employer:
19.
How long have you been employed there?
20.
Martial Status:
21.
Partner's Name:
22.
Age:
23.
How many hours a day would the pet be left alone?
24.
Have you ever owned dogs before?
25.
If so where is that dog(s) now?
26.
Is this a gift for someone?
27.
Why have you chosen to adopt a rescue?
28.
Does everyone in the family want this dog?
29.
How many adults are in the household?
30.
How many children (List ages/sexes)?
31.
What other pets are in the household?
32.
Are they spayed or neutered?
33.
What type of home are you in?
34.
Do you own or rent?
35.
If rent, please provide landlord's name and number:
36.
If rent, are you allowed to have pets? Any pet restrictions?
37.
Are you planning on moving in the near future?
38.
What if you had to move to a place that didn't allow pets?
39.
What will you do with your pets if life circumstances change, ie: divorce, separation, death in the family?
40.
Are you acquainted with a nearby veterinarian?
41.
Veterinarian name and number:
42.
Do we have permission to contact your veterinarian and landlord?
43.
Do you have a fenced in yard (describe)?
44.
How long will the dog be left alone outside?
45.
Where will your dog be kept during the day?
46.
Where will your dog be kept at night?
47.
What accommodations will you make for your dog if you go away on vacation?
48.
How will you exercise your dog?
49.
Are you prepared to make a lifetime commitment to this dog?
50.
Are you prepared to devote extra time and or training in the beginning?
51.
Until your dog learns the rules of your home, he may urinate or defecate in your home, and may chew household items.
How will you handle this?
52.
Please describe how you will discipline your dog?
53.
How will prevent fleas/ticks?
54.
How will prevent heartworms?
55.
I'd give up my pet if:
56.
If for any reason you are unable to keep this dog, do you agree to return this pet to Rescue Rehab Home?
57.
Do you have any objection to a volunteer visiting your home?
By submitting the form below, you certify that the above information is true and correct.
RRH will not share or sell your information
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