Welcome to A Doggie 4 You

Companion Pet Application

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
-

Email*

Home Phone

Cell Phone

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Today's date*

Which animal are you interested in*

Why are you interested in adopting a pet at this time*

Do you own or rent?*

If you rent, have you received the approval of your landlord to have an animal

Yes

Will you have to pay a pet deposit?

Yes

What restrictions, if any, are there on the type of pet you may have?

In what type of home do you live*

Do you have other dogs, what breeds and how many? Do they get along with other dogs?*

Are your pets spayed/neutered?

yes	no
some

If any of your dogs are not spayed or neutered please explain why

Do you have other pets or animals? If yes, what type and how many*

If any of your animals were adopted from a rescue agency, how many and what agency(ies)?

Veterinarian's Name and Phone Number

What type of flea/tick prevention do you use? If none please state NONE.*

What heartworm prevention do you use and where do you purchase it? If you do not use heartworm prevention please state NONE*

Where do your dogs live?*

Inside Night, Outside Day	Inside Only
Inside/Outside for potty	Outside Only

How much time will the animal spend alone during the day*

Where will the animal be kept when you are not home*

Where will the animal sleep*

How many people reside in your household*

Ages of each occupant in the home*

Who in the household will care for the pet*

Have you ever lost, surrendered or given away a pet? If yes, why?*

Is your yard fenced*

What type of fence

What is the height of the fence

What type of protection does your dog have outside? *

Are you willing/able to provide Financial support for her yearly shots and other medical issues that may occur? *

Yes

Are you willing to work with medical/behavioral issues*

Yes

Who will take care of your dogs if you become disabled or unable to care for them?*

What will you do with the dog if you have to move from your current home?*

ALL PETS ADOPTED THROUGH THE A Doggie 4 U PROCESS WILL BE AS COMPANION PETS ONLY. THAT MEANS THAT THE PET WILL BE TREATED AS A MEMBER OF YOUR FAMILY AND ALLOWED INTERACTION WITH THE FAMILY DAILY. PETS ARE NOT TO BE USED AS GUARD DOGS. THESE PETS ARE NOT TO BE KEPT CHAINED IN A YARD OR OTHERWISE CONTAINED WITHOUT AMPLE ROOM FOR EXERCISE. THEY ARE TO BE KEPT CURRENT ON THEIR VACCINATIONS AND HEARTWORM PREVENTION. THESE PETS ARE TO BE GIVEN PROPER MEDICAL CARE WHEN NEEDED AND PROVIDED WITH SAFE AND ADEQUATE SHELTER AT ALL TIMES. FRESH FOOD AND WATER WILL ALWAYS BE MADE AVAILABLE TO THESE PETS. SOME OF THESE PETS HAD A ROUGH START IN LIFE AND WILL NEED EXTRA LOVE AND ATTENTION. I UNDERSTAND THE ABOVE AND WILL DO MY VERY BEST TO GIVE THIS PET A LOVING HOME. SUMISSION OF THIS APPLICATION INDICATES YOUR AGREEMENT TO THESE CONDITIONS. IF YOU HAVE ANY QUESTIONS YOU MAY INDICATE THEM BELOW.

How did you hear about us*

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