EmailMeForm
Palmetto Paws Adoption Application
Thank you for your interest. Completion of this form does not guarantee that you will receive an animal from us. There are many things we take into consideration when reviewing applications. We reserve the right to deny any applicant. Our goal is to match the right animal with the right home. Incomplete applications will not be considered.
Name of dog for which you are completing this application:
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Date Time
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MM
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Name
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First
Last
Address
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City, State, Zip
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Phone Number
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Alt Phone Number
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Email
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Are you?
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Married
Single
If Married, Spouse's Name:
What is your occupation?
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Your Spouse's occupation?
List AGES of all people living in your home: INCLUDING YOURSELF.
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Where do you live?
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House
Apartment
Condo
Townhouse
Mobile home
Do you:
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Own
Rent
If you rent, please provide your landlord's contact information.
Are there any breed restrictions/HOA restrictions where you reside? (please review your HOA and and lease documents if indicated)
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If you move, will you be sure to secure housing that will accommodate your pet?
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Yes
No
Who will be responsible for the welfare of the dog?
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Does anyone in the household have allergies to pets?
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Yes
No
If yes, please explain:
Do you prefer:
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Male
Female
Either
Why?
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Are you interested in:
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Puppy
Older dog
Why?
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Are you committed to caring for this dog for its lifetime - this includes moving with your pet, working through training issues, managing health issues - and making this pet an unconditional lifetime family member?
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If something should happen to you, what arrangements have you made for your pet(s)?
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How much money are you prepared to spend should a major health issue/accident happen?
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How much time will the dog be left alone?
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Where will the dog stay during the day?
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If you are looking to adopt a puppy less than 3-4 months of age, and you are gone longer than four hours at a time, what arrangements have you made for the puppy?
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Where will the dog sleep?
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Are you familiar with crate training?
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Yes
No
Do you have a fenced yard?
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Yes
No
Fence type and height:
Do you plan to chain, tether, or put the dog on an overhead runner?
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Yes
No
Other pets currently owned:
Name
Breed
Sex
Age
Spayed/Neutered
1
2
3
Are all of your current pets up to date on vaccines?
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Yes
No
N/A
If you have dogs, are they current on heartworm prevention?
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Yes
No
N/A
List all previously owned pets in the last 5 years and the reason you no longer have them
Name
Breed
Reason
1
2
3
Tell us what you know about heartworm disease. Your answer MUST include prevention, treatment, and prevalence in this area. *If you are unfamiliar with heartworm disease, it is expected that you conduct research to fully answer the above question.
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Who is your current or prior veterinarian?
Veterinarian's Phone Number:
What owner name are the vet records/pets under?
How do you correct unwanted behaviors in a dog? Please give an example.
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Have you ever taken a dog to obedience classes?
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Yes
No
If so, where?
Please tell us anything else about yourself that you would like us to consider in the adoption process:
How did you learn about our organization?
If your application is approved, are you able to meet and potentially adopt this Saturday at a time designated by the rescue?
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Yes
No
I declare that the above is true to the best of my knowledge and ability. I authorize the Veterinarian listed about to release medical information of my current or prior pets.
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Clear
