Adoption Application Adoption ApplicationWhich UnderDog are you interested in adopting?* Contact InfoName* 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?*YesNoDoes anyone in our household have allergies or Asthma?*YesNoIf you have visitors, do you have a way to separate your dog from them if it is uncomfortable?*Your HomeDo you have a pool?*YesNoDo you live on a canal?*YesNoDo you have a fence?*YesNoIf yes, what type? Wood or chain link? What height?Does your home have a doggie door?*YesNoIf you do not have a yard, how do you plan to exercise the dog?Type of Residence*House-ownHouse-rentApartment/CondoMobile HomeOtherIf you rent, please give your landlord's name and phone number:Do you live in a deed restricted area?*YesNoYour LifestyleHow many hours a day would the dog be alone?*0-2 hours2-4 hours4-6 hoursover 6 hoursWhile you are away, will the dog be kept in a crate?*YesNoWhere 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?*YesNoHave you ever house-trained a dog before?*YesNoIf 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 PetsCurrent pets name, breed, age:Previous pets name, breed, age:What happened to your previous pets?Do you keep your pets indoors our outdoors?*IndoorsOutdoorsDo you keep your pets on heartworm preventative?*YesNoAre your pets up-to-date on their vaccines?*YesNoWill your pets accept a new dog into the household?YesNoPlease 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?*Additional CommentsIs there anything else you would like to add?CAPTCHA