EmailMe Form - PRE-ADOPTION APPLICATION

Name *

First Last

Date of Birth *

Name of dog(s) you're interested in adopting?

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

State ID/Driver's License # *

Phone *

### - ### - ####

Secondary Contact Number

### - ### - ####

Email *

What is your occupation? *

How many hours a week do you work? *

Do you live in... *

How long have you lived at your current address? *

Do you own, rent or lease? *

Own

Rent

Lease

As a Renter, do you have the Landlord's permission to have a dog? At time of adoption, please provide proof of your lease/rental agreement.

Yes

No

Please explain any restrictions (breeds, weight, etc) AND please provide Property Management Name and Telephone Number:

Do you have plans to move? *

Yes

No

N/A

If yes, when and where? Please explain.

Do other adults live in the home? If yes, please list ages of each adult household member. *

Does anyone in the household smoke? *

Yes

No

Do children live at or visit the home (Yes or No)? If so, please provide their ages. *

Are the children experienced around dogs? *

Yes

No

N/A

Is anyone in the home allergic to pets? *

Yes

No

Is anyone in the home afraid of dogs? *

Yes

No

If you have a yard, who has access to your yard? *

Does anyone come to your property while you are not there? (ie housekeeper, maintenance, repair) Please explain. *

Where will your dog be during those times? (Please be specific) *

Do you have fencing? If yes, please specify height and type of fencing. *

How tall is your fence at its lowest point? *

Do you have a locked gate? How tall is your gate? *

Do you have a swimming pool? *

Yes

No

If yes, is your pool area fenced?

Have you ever had a dog before? *

Yes

No

If Yes, for how long? If you no longer have it, what happened to him/her?

Do you have a dog(s) now? *

Yes

No

If yes, please provide Breed, Gender and Age of each.

Do you have any other pets? *

Yes

No

If so, what kind?

Are your pets spayed or neutered? *

Yes

No

N/A

Have you ever lost a dog? *

Yes

No

Please explain

If your dog is LOST, which of the following will you do? (check all that apply) *

Do you think its necessary for your dog to wear an ID tag? *

Yes

No

Not sure

Have you ever relinquished a pet to a shelter or rescue? *

Yes

No

Have you ever had an animal confiscated from you? *

Yes

No

Have you ever had to euthanize a pet? If so, please explain. *

Do you have any livestock? *

Yes

No

Do you anticipate any problems with current pets and a new dog? Should any arise, how would you deal with those problems? *

Will your dog be Indoor only, Outdoor only, or Both? *

Outdoor only

Indoor only

Both Indoor & Outdoor

What Percentage % of Time
will the dog be Outside % - Inside % ? *

Do you have a dog door? *

Yes

No

Thinking about getting one

Which rooms in your home are off limits to your dog? *

Is your dog allowed on the furniture? *

Yes

No

Is anyone home during the day? *

Yes

No

When you are not at home, where will your dog be? *

How many hours will the dog be alone on average? *

Where in your home will your dog sleep? (Please be specific) *

What brand of dry dog food will you be feeding your dog? How often? *

What brand or type of dog treats, if any, will you feed your dog? How often? *

Have you considered feeding a fresh whole food diet? What would you choose? *

Raw food

Dehydrated/Freeze Dried

Homemade recipe

Not my choice

When you go on vacation, who will care for your dog? *

House/Pet Sitter

Vet/Boarding Kennel

Friend/Relative

Neighbor

In the past, have you ever been forced to give up your dog? *

Yes

No

If yes to the above, what did you do? *

What will you do if you can no longer keep your pet? *

Which of the following will you use for flea control? (Check all that apply) *

What will you do if your dog gets sick? *

Do you know how much vet care costs? *

Are you prepared to spend the money, if needed? *

Yes

No

Do you have a limit? If YES, please explain. *

To protect your pet, would you consider subscribing to a Pet Insurance plan? *

Yes

No

If you have a Current Veterinarian, what is the Name & Telephone Number: *

How will you get your dog to do what you want it to do? *

Have you ever trained a dog in professional obedience class *

Yes

No

Do you still use the same training methods? *

Yes

No

Training has evolved, I'd enjoy learning new methods

What will you do if your dog chews/destroys a non-dog item? *

Under what circumstances will you give up your dog? (Check all that apply) *

If dog were to do one of the above behavior issues (ie nipping, biting, barking, digging, etc) are you willing to consult a professional trainer to try and rectify the situation before giving up on the dog? *

Yes

No

How do you plan on exercising your dog and how often? *

In case you are unable to exercise your dog for a period of time, how would you handle it?

Get an experienced dog walker

Dog has a backyard

Dog will wait till I can

A pet requires a lot of human attention. Are you prepared, committed and patient enough to spend a lot of time with your new pet for the rest of its life? (15+ years) *

Yes

No

Do you understand a dog needs time to adjust and decompress at their new home? *

Yes

Not sure

Apply the rule of "3"

Are you willing to update the rescue if contact information/address changes so their records can be updated? *

Yes

No

Please answer each of the following:
A) What are you looking for in the dog you're interested in adopting?
B) How much do you know about the breed(s) of the dog(s) you're interested in? *

Please feel free to add any other information you think would be useful for us to know or are there any concerns you would like to discuss? *

Do you consent to a home visit by ASFP personnel upon request? *

Yes

No