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Pet Placement Form
Full name
Date of birth
Address
Rent or Own
Choose an option
How long have you lived at this address?
Email
Phone
City & Zip
Landlord Name & Phone Number
Do you have plans to relocate?
Employer
List other members of household here. If none, type N/A.
Does anyone in household have special needs? If yes, please describe.
Does your residence have a body of water behind it or near it?
Do you have a pool, sauna, or jacuzzi?
What type of animal are you interested in adopting?
Do you prefer a male or female?
Do you have a fence? If yes, please describe. If no, type N/A.
In general, how long will the pet be home alone in an average day? Where will the pet be when you aren't home?
Where will the pet sleep at night?
Preferred age - check as many as apply:
Under a year
2-5 yrs old
5-8 yrs old
Over 8 yrs old
Any of the above
Weight range (check one):
Under 25 lbs
25 - 40 lbs
40 - 60 lbs
Over 60 lbs
Why do you want this dog (or cat/bird/etc.)?
Will the pet be kept indoors or outdoors? Please elaborate.
Do you currently have any other animals? If yes, please list them by type, breed, age, gender, and indoor/outdoor. If not, please type N/A.
If you have pets, are they on heartworm preventative?
If you have pets, are they spayed or neutered?
Does anyone in the household have allergies?
If you have pets, are the up-to-date on vaccines?
Are there any smokers in the house?
Do you have a doggie door?
On average, how long will the dog be left alone each day? If not adopting a dog, type N/A.
What plans do you have for excercising the pet?
Do you have a crate? Feelings vary about crates, so please elaborate about how YOU feel about them and if/when you'll use a crate for this dog. If not adopting a dog, type N/A.
Do you have other pets? Please tell us about them?
Do you plan on isolating the pet from other pets during the first week?
Do you grant permission to contact your veterinarian?
Provide the name & phone number of your veterinarian. If none, type N/A.
Please list prior pets. Include type, breed, time frame you had them, and where they are now.
Please provide 3 personal references (maximum of one family member) and make sure they know they will be contacted.
Additional comments
By typing your name below, you certify that all the information contained in this application is true and correct.
Apply
Thank you! We’ll be in touch.
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