Dog Adoption Form

Pre-Adoption Questionnaire for Dogs and Puppies

Please complete the following form and submit your pre-adoption application for review:

* Required Entry: Please note if you leave required fields blank you may receive an image verification error. You must fill in all fields that have an *

Name*:
Home Phone*:
Cell Phone:
Dog or Puppy applying for by name:
Dog or Puppy applying for by P or D #:
Address*
Apt.#
City*:
State*:
Zip Code*:
Employer:
Work Phone:
Email Address:
Best number to call you weekdays?

The Humane Society:

How did you hear about us?
If Other chosen, please explain:
Would you like to find out more about volunteering, fostering, or socializing animals?
Have you ever had to turn an animal in to a shelter before?
Have you ever applied to adopt an animal from the Humane Society of Forsyth County?* (Must choose one)
Have you ever adopted an animal from the Humane Society of Forsyth County?* (Must choose one)
If yes, who did you adopt?
Would you agree to a home visit from a Humane Society Volunteer as a condition of adoption?*(Must choose one)
What's this about a home inspection?

Your New Dog or Puppy:

Why do you want a dog?*:
If Other chosen, please explain: *
Will it be indoors, outdoors, or both?*
Where will he or she sleep?*
What percentage of time will the dog spend:	Outside? * Inside? *
Who will be the primary adult responsible for training?*
Are all your current pets up to date on vaccines?
On Heartworm Preventative?
If so, what kind?
On Flea Preventative?
If so, what kind?
Please list all pets your family has owned in the past 5 years, including where they are now, Doctor that animal was seen by including Vet's phone number.
Do you give Humane Society of Forsyth County permission to contact vet? *

Pet 1:
Where are they now?
If other, please explain:
Veterinarian Clinic/Doctor:
Contact Information - phone:
Pet 2:
Where are they now?
If other, please explain:
Veterinarian Clinic/Doctor:
Contact Information - phone:
Pet 3:
Where are they now?
If other, please explain:
Veterinarian Clinic/Doctor:
Contact Information - phone:
More than 3?
If yes, you can provide Humane Society of Forsyth County (HSFC) more details later.
How much would you expect to spend yearly on routine vet visits, health care, and food for this pet?* $
(Expenditures include, annual vet checks and shots, healthy food, dental care, heartworm and flea preventative.)
Are you willing and able to make a commitment to do this routine vet/health care including heartworm and flea preventative every year?*
Do you agree, for the pets safety, to keep an ID tag on this animal at all times?*
The HSFC has provided one for each animal, or you may choose to purchase one with your information.
*If Outdoors: Is your yard fenced?
If No, please explain how you will contain your new pet:
Do you have a pen or tie out?
What accommodations can you make for weather extremes?
How often will you check food and water?*
*If Indoors: Is your yard fenced?
If No, how will he/she be taken out?
Have you ever housebroken a dog?
Have you owned or lived with an indoor dog before?
Have you ever "Crate Trained"?
How many hours will the dog need to crated each workday?

Your Home and Family:

How many people in your home?* Do you have children in the home?*(Please choose one)

If Yes, what ages?

Are the children experienced with dogs?*(Must choose one)

Is an adult home during the day?*(Please choose one)

Do you rent or own home? * If you rent, are you allowed pets? Weight Limit? pounds Pet Deposit? $

How long have you lived at your current address?* Years Months Do you plan to move in the next 12 months?*(Must choose one)

References (Optional):

If you know a member of the Humane Society of Forsyth County you would like us to contact for a personal reference, please use the space below.

Reference Name:
Relationship:
If Other, please explain:
Reference Phone Number:
Reference Email:

If there is an animal care professional or other rescue organization you would like us to contact for a personal reference, please use the space below.

Reference Name:
Relationship:
If Other Rescue, please give name of the rescue group:
Reference Phone Number:
Reference Email:

Do you agree to return your pet to HSFC if your conditions change and you are no longer able to care for your dog? Yes, I agree OR No, I disagree *

Are you willing to accept this pet as a part of the family, and give it a kind and loving home? Yes, I agree OR No, I disagree*

Are you at least 21 years of age? Yes, I agree OR No, I disagree * Date of birth?

I, hereby certify that all the information above is true and correct and authorize HSFC to verify any and all information provided for purposes of adoption. I also understand that any untruthfulness will automatically cause my application to be declined.*

Please enter the validation code below (black letters only):

After pressing the Submit button, just once, wait a few moments, you will get a confirmation page

	Adoption Information
	Online Application Dogs
	Online Application Cats
	Senior Cats
	Special Needs Dogs
	Special Needs Cats
	Printable Forms
	Dog Adoption Form
	Cat Adoption Form

Schedule of Events

Adoption Quicklinks

Featured Dog