COMPANION CRITTERS, INC.
DOG and PUPPY ADOPTION APPLICATION
The following information is requested so we can assist you in the selection of a new pet. The animal's welfare is our foremost concern. The consultation process is designed to help us assist you in finding the animal most compatible to your lifestyle.
Please complete all of the information on the application. We regret that incomplete applications cannot be considered. Please give careful consideration to adopting a pet. Animals are not short-term commitments. Make sure your lifestyle allows the time, patience and expense this pet will need over the years. Animals for adoption are placed with full consideration given to the specific needs of each animal
Name of pet for which applying:
The reason I would like to adopt this particular pet:
Are you over 18 years of age?
I am adopting for
I am prepared to adopt this pet
PLEASE NOTE: If you checked off later than "1 week from now" please check back when you are ready to adopt and apply at that time as we do not have the foster space to hold animals.
Name of Person(s) Applying to Adopt:
Address.
City:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Is this your first experience with a pet?
Do you currently have any pets in your home?
*If yes, please complete for each pet:
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Pet #1 is a
Name:
Age:
Breed:
How long have you had this pet?
Is this pet up to date on vaccinations?
What brand heartworm preventative do you use?
What brand flea/tick preventative do you use?
This pet is a
This pet spends
% time indoors
% time outdoors
Please tell us about this pet
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Pet #2 is a
Name:
Age:
Breed:
How long have you had this pet?
Is this pet up to date on vaccinations?
What brand heartworm preventative do you use?
What brand flea/tick preventative do you use?
This pet is a
This pet spends
% time indoors
% time outdoors
Please tell us about this pet
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Pet #3 is a
Name:
Age:
Breed:
How long have you had this pet?
Is this pet up to date on vaccinations?
What brand heartworm preventative do you use?
What brand flea/tick preventative do you use?
This pet is a
This pet spends
% time indoors
% time outdoors
Please tell us about this pet
If there are currently more than 3 pets, please list the same information as above for the others:
Have you had any pets in the past?
*If yes, please complete:
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Past Pet #1 was a
Name:
Age:
Breed:
How long did you have this pet?
Was this pet up to date on vaccinations?
What brand heartworm preventative did you use?
What brand flea/tick preventative did you use?
This pet was a
This pet spent
% time indoors
% time outdoors
Please tell us what happened to this pet:
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Past Pet #2 was a
Name:
Age:
Breed:
How long did you have this pet?
Was this pet up to date on vaccinations?
What brand heartworm preventative did you use?
What brand flea/tick preventative did you use?
This pet was a
This pet spent
% time indoors
% time outdoors
Please tell us what happened to this pet:
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Past Pet #3 was a
Name:
Age:
Breed:
How long did you have this pet?
Was this pet up to date on vaccinations?
What brand heartworm preventative did you use?
What brand flea/tick preventative did you use?
This pet was a
This pet spent
% time indoors
% time outdoors
Please tell us what happened to this pet:
Have you ever taken a pet to a shelter or had to rehome your pet?
*If yes, please describe the circumstances:
Who is/was your veterinarian?
Name of veterinary practice:
Address of veterinary practice:
Phone number of veterinary practice:
Approximately when was your last visit:
Under who's name (pet's owner) are the pet's records?
Do we have your permission to contact your veterinarian?
You currently live in a
How long have you resided at this address?
You currently
* If you rent, are pets allowed?
Landlord's name:
Landlord's phone number:
May we contact your landlord?
** If you live at home with your parents, do you have your parent's permission to adopt?
What would you do with your pet if you had to move where pets aren't allowed or if you were no longer able to care for your pet?
Under what circumstances would you find it necessary to give up your pet?
How many people live in your household?
Is everyone in the family in agreement with adopting a pet?
How many children live in the household and what are their ages?
Who will have primary responsibility for the care of this dog?
If children (any household member under 18) are expected to have responsibilities, please describe to what extent.
Does anyone in your household have allergies to dogs?
Where will this pet be kept during the day?
Where will this pet be kept during the night?
Where will the pet be kept when left alone?
Is anyone home all day?
*If no, how many hours will the pet be left alone in a 24 hour period?
You might have to housetrain a dog or a housetrained dog could experience accidents while adjusting to a new home and routine. Are you prepared to deal with that?
Please describe what methods you use for housetraining or reinforcing housetraining:
What will you do if the dog chews furniture or shows other destructive behavior?
Have you ever crate trained a dog before?
Would you consider crate training a dog?
Have you ever formally obedience trained a dog before (attended obedience classes)
Would you be willing to attend obedience classes?
Please describe vistors (human or animal) to your home with which your dog must get along:
You would like to adopt this dog as a:
Family Pet
Guard Dog
Watch Dog
Companion
Gift
Breeder
Companion for another pet
Other:
How will you keep your dog confined to your property?
Outside Dog Pen/Kennel/Dog Run
Invisible/Electric Fence
Fenced Yard
Chain or Tie-Out
Garage
Patio/Deck
On Leash
Other:
If your yard is fenced, please describe if it is fully or partially fenced, what type of fencing and height of the fence.
If you do not have a permanently fenced yard or if your yard is partially fenced, please describe how you will handle the dog's exercise and toilet duties:
To help us better determine if the dog's activity level is compatible with your lifestyle, please indicate which activities you and/or your family would want to participate in with your dog:
Other:
Please tell us anything else about yourself that you would like for us to take into consideration or list any additional questions you might have.
We request an adoption fee of $250. This donation is to help offset the costs incurred for veterinary care. Each animal coming through rescue costs us an average of $400 and the rest is made up through additional donations and fundraisers. Is this acceptable?
For puppies under the age of 6 months, we require an additional $50 deposit which is refunded upon proof of completion of a puppy training or obedience course. Is this acceptable?
By signing below, you certify that you understand the following:
Companion Critters, Inc. reserves the right to refuse adoption to anyone.
The information contained within this application is accurate and not misleading in any way.
Companion Critters, Inc. reserves the right to contact individuals listed on this form for verification.
Would you be willing to let a representative from Companion Critters, Inc. visit your home by appointment?
Electronic Signature:
Date:
Please check to be sure you typed your email address correctly. We respond to all applicants so if you do not hear from us, it would be because your email address is incorrect.
