Please tell us about your co-applicant (spouse or significant other), if applicable

Animal(s) of Interest

May a representative from the rescue group visit your home by appointment?

Please check any of the following reasons for adopting this pet

Please tell us about your home

Please indicate where you live

Do you

Do you foresee any major changes in your life in the next 15 years

Do you have a fully fenced yard?

Does anyone in the household smoke?

Will this pet be a surprise for any family members?

Do any family members have allergies?

Do children live in the house?

Please tell us about your current pets and pet experience

Do any of your current pets or did any of your past pets live primarily outdoors?

Were all your previous pets spayed/neutered?

Are all of your current pets spayed/neutered?

Do you know what heartworm disease is and how to prevent it?

Do/did you use heartworm prevention?

If you are applying for a cat, do you plan to declaw your new cat/kitten?

Have you always kept an ID tag with your phone number on your pet(s)?

Do you have a pet door?

What circumstances, in your mind, justify giving a pet up?

Have you ever given a pet up or had a pet and it didn't work out?

Have you ever looked at or applied for a pet with another shelter or rescue group?

Did you adopt?

Has a dog, puppy, cat or kitten died on your premises in the last 6 months?

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