Adoption Application

Which UnderDog are you interested in adopting?*

Contact Info

Name*

First Last

Email*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Age*

Please list other people in your household: names, age and relationship.*

Who is the primary caretaker of the dog?*

What types of personalities do you find desirable in a dog?*

Is everyone in the household agreeable to a new dog?*

Yes
No

Does anyone in our household have allergies or Asthma?*

Yes
No

If you have visitors, do you have a way to separate your dog from them if it is uncomfortable?*

Your Home

Do you have a pool?*

Yes
No

Do you live on a canal?*

Yes
No

Do you have a fence?*

Yes
No

If yes, what type? Wood or chain link? What height?

Does your home have a doggie door?*

Yes
No

If you do not have a yard, how do you plan to exercise the dog?

Type of Residence*

If you rent, please give your landlord's name and phone number:

Do you live in a deed restricted area?*

Yes
No

Your Lifestyle

How many hours a day would the dog be alone?*

0-2 hours
2-4 hours
4-6 hours
over 6 hours

While you are away, will the dog be kept in a crate?*

Yes
No

Where will the dog be kept while you are at home?*

Where specifically will the new dog be kept during the day?*

Where will the new dog sleep at night?*

Do you feel it is acceptable to let your dog off-leash in an open area?*

Yes
No

Have you ever house-trained a dog before?*

Yes
No

If yes, what method did you use?

Are you willing to:

Crate-train
Adopt a bonded pair
Adopt a dog needing house-training
Adopt a dog requiring ongoing meds
Adopt a dog NOT reliable with children
Adopt a dog that is handicapped or blind
Adopt a dog that may have been abused

Current/Previous Pets

Current pets name, breed, age:

Previous pets name, breed, age:

What happened to your previous pets?

Do you keep your pets indoors our outdoors?*

Indoors
Outdoors

Do you keep your pets on heartworm preventative?*

Yes
No

Are your pets up-to-date on their vaccines?*

Yes
No

Will your pets accept a new dog into the household?

Yes
No

Please provide your veterinarian's name.*

Please provide your veterinarian's phone number.*

If applicable, please provide your FORMER veterinarian's name.

If applicable, please provide your FORMER veterinarian's phone number.

Is the pet listed under your name? If not who's name?*

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