Dog Adoption Application 2017

MUTT RESCUE ADOPTION APPLICATION
This questionnaire is designed to help Mutt Rescue and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Mutt Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Name of the dog you are interested in:*
Your full name:*
Your age:*
Street Address:*
City, State, ZIP CODE*
Date:*
Home Phone:*

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:*

Area CodePhone Number
Email:*
Spouse/Partner Name and phone number*
Employer:*
3 Character References and Phone Numbers:*
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
What type of activity level is your household?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, please provide landlord's name & number. If you don't rent, put "N/A" in the box below:*
Does your landlord allow dogs?*

YesNoN/A
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence*
Do you have any of the following?*

Underground fenceKennelDog RunNone
How many adults are in your household, INCLUDING their ages, and what is their relationship to you?*
How many children are in your household? *
What are their ages?
Have your children been around animals before?*

YesNoN/A
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past and where are they now, INCLUDING their breed and age?*
Have you ever rescued before? If yes, what rescue?
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:*
New Pet Information
What type of personality do you want your pet to have (i.e. calm, energetic, protective, couch-potato?*
Are you aware of how to properly crate train if you choose to do so?*

YesNo
Have you ever potty trained a dog or puppy before?*

YesNo
If the dog has an "accident" in your home, what do you do?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behaviors?*

YesNo
Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for?*

YesNo
Do you plan to take an obedience class with your dog?*

YesNoNot sure
Are you aware that all breeds can take up to FOUR years to mature? Is this something you're prepared for?*

YesNo
Do you understand that it might take up to 6 months for a dog to adjust to its new family AND environment and that you cannot bully your dog into being brave by introducing those things that can play a negative role in his/her life immediately after adoption?*

YesNo
What circumstances would lead you to give up your new dog?*
If you had to give up a pet? What would you do with him/her?*
How did you find out about Mutt Rescue?*

Adoptapet.comPetfinder.comFacebookOther___________PetSmart
**Behavior problems can arise for many reasons and most CAN be solved. Do you agree to seek help/assistance to resolve these issues rather than give up your pet?*

YesNo
**Please remember that HANDS ARE A GOOD THING! Never reprimand or point a finger at any dog's face! Tug-of-war games only build aggression in a dog! Always ask yourself if you have given your dog enough mental and/or physical exercise because a tired dog is a happy dog and a well-behaved dog. Do you understand all of these statements?*

YesNo
**Mutt Rescue's owner is a behavioral specialist and offers FREE BEHAVIORAL ADVICE at any time to make the transition as easy as possible.
**DO NOT reprimand your dog if you come home to a mess whether it be potty or destruction. ITS TO LATE. If your dog has something in its mouth thats not a toy, please substitute what's in its mouth with what he/she CAN chew. If you come home to a potty mess, pick it up and don't get angry. Your anger will teach your dog to eat the evidance. Please potty train properly. Do you understand these statements?
YesNo
**IF YOU HAVE MORE THAN ONE DOG, I HIGHLY RECOMMEND THAT YOU REMOVE THEIR COLLARS FOR WHEN THEY PLAY EITHER INDORRS OR OUT. ONE'S JAW CAN GET CAUGHT UNDER THE OTHER'S COLLAR AND CHOKE THE OTHER DOG, CAUSING BROKEN JAWS, BROOKEN BLOOD VESSELS, EYES BULDGING OUT OF THEIR SOCKETS OR DEATH. DO YOU UNDERSTAND THIS STATEMENT?*

Yes
I agree to all of the above that each question has been answered honestly and accurately.*

Yes
Should be Empty:

MUTT RESCUE ADOPTION APPLICATION

Household Information

Current/Previous Pet Information

New Pet Information