Adopt - Lucky Dog Rahab

Adoption Info

Please complete our adoption form below to get the process started. The process consists of the following:
Foster to adopt only:
• Application • Home Visit • Vet Records • 2 – Reference • Landlord sign off in renter

Name *

First

Last

Email *

Your Date of Birth

Your Cell # *

What is your profession and employer?

Is there a particular pet you're interested in? If so, please specify name and shelter ID# (if applicable):

If none in particular, please tell us if you have an age, gender, and breed preference?

How did you learn about this pet and/or Lucky Dog Rehab?

Do you want to adopt, foster, or both?

Do you presently reside with any other co-applicants, who are adults that have a role in household decision making?

Co-applicant's full name

Co-applicant's phone #

Co-applicant's email

Co-applicant's date of birth

What is the coapplicant's profession and employer

Applicant Street address *

City *

State *

Zip/Postal Code *

What type of home do you reside in?

What type of yard does your home have?

Do all of your windows have secure screens?

Do you own or rent your home?

If you are renting, we are required to obtain your landlord’s permission prior to placing a pet at your residence. Please provide us with your landlord’s name and contact info:

Other than the coapplicant, please list ALL other residents of your household and their ages below:

Is EVERYONE in the household in agreement to adding a new pet to the family?

Please tell us about all pets that are currently living in your home? (breed, gender, age, special needs, etc.)

Are all current pets up to date on vaccinations?

Are all current pets spayed and/or neutered?

If any are not spayed or neutered, please explain why

Are your pets on heart worm preventative?

Please tell us about the types of pets/breeds you have previously owned and/or have experience with

Tell us why you wish to add a new pet to your family

Please give us a brief description in your own words of what specific behavioral/medical needs the pet you are applying for has and include your plans to address/manage those challenges

If you are applying for a dog, please tell us what activities you plan to do with your new pet

What provisions will be made for your pet when you go on vacation?

If you are applying for a dog, please tell us what provisions will be made for your pet if alone during the evening

If applying for a dog, do you intend to use the pet as a guard dog?

Under what circumstances have you ever or would you ever give up your pet?

Have you ever had a pet lost or injured? If so, please explain. If not, type "none"

VET INFORMATION: Which veterinary practice do you currently use? *

Veterinarian's Phone # *

REFERENCES:Personal Reference # 1 Full Name

Reference #1 Phone #

Reference #1 relationship to you

Personal Reference # 2 Full Name

Reference #2 Phone #

Reference #2 relationship to you

AGREEMENTS: If you are adopting a pet, do you agree to provide an adoption fee to help cover our costs of spay/neuter, all shots, microchip and transport, and other related Yes, I agree to pay an adoption fee expenses? The fee can range from $150 to $400 depending on age and circumstances and is *non-refundable.* *

Agree

Do you agree to provide Lucky Dog Rehab with occasional updates and/or photos of your pet in the future? *

Agree

It is important that we are able to remain in contact with our foster/adopters, donors, and supporters. Please note that Lucky Dog Rehab reserves the right to contact you via the methods provided on this application. As such, you may be added to our e-mail and text lists. We will never share your information and you can unsubscribe at any time. *

Agree

I certify that the information I have provided on this form is true, correct, and accurate. *

Agree

I certify that I am financially and physically able to care for the animal that I adopt. *

Agree

I understand and agree that falsification of any of the above information is grounds to disqualify and/or nullify all agreements. *

Agree

I understand that Lucky Dog Rehab is under no obligation to place an animal with me, now or in the future. *

Agree

I understand and hereby agree that I am able and prepared to keep my new pet *separated* from any existing pets upon arrival at the home. This separation period may take anywhere from several days to two weeks depending on the health conditions and readiness of my new pet to be fully integrated into the family. I agree to abide by the recommendations set forth by Lucky Dog Rehab with regard to time period for separation. *

Agree

I hereby understand and agree that my new pet will NOT be immediately introduced to existing pets in the home upon arrival. I understand that my new pet will need ample time for decompression and Lucky Dog Rehab can provide literature on proper methods and time periods for decompression as well as how to properly introduce a new pet to existing pets so there will not be any conflicts. *

Agree

I hereby understand and agree that should there be any extenuating circumstances where I am unable to keep the new pet, I will immediately contact Lucky Dog Rehab for further instruction and I hereby agree to allow UP TO TWO WEEKS for Lucky Dog Rehab to retrieve the animal, during which time I understand I may need to keep the animal separated from existing pets and or children in the home if any conflicts have arisen. Under NO circumstances will I rehome the pet, drop the pet off at a shelter or with animal control, or tie or release the pet outdoors. *

Agree

I understand that my electronically-provided signature [below] is valid as a means of legal signature for the purpose of this foster/adopt application and that a background check may be performed. *

Agree

DIGITAL SIGNATURE: Type full name to electronically sign. Typing in your name below constitutes your legally-binding signature to this agreement. *

Type your initials. Typing in your initials below constitutes your legally-binding signature to this agreement. *

Today's Date *

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