DOG ADOPTION APPLICATION
T
his application MUST be completed by anyone interested in adopting a pet from PAWS Atlanta.
PAWS Atlanta reserves the right to refuse an adoption for ANY reason. All applicants must be 21 years
or older and provide a valid ID. All applicants interested in breeds historically used for guarding or
fighting (Rottweilers, Pit Bulls, Dobermans etc.) will have their application reviewed by the shelter
manager, and adoptions may not be same-day. We want this to be a wonderful experience for you and
your family, but our first responsibility is for the health, welfare, and happiness of the animals in our care.
Personal Information
N
ame:_____________________________________________________________________________
Home Address:______________________________________________________________________
City:________________________ County:______________ State:____________ Zip: _____________
Home Phone:_____________________ Work Phone:_____________________
Other:______________________________________________________________________________
Occupation:_________________________________________________________________________
Email:______________________________________________________________________________
Would you like to receive invitations to PAWS Atlanta events and fundraisers? _________________
W
ill the animal live at the address above? Yes No
If “No”, please give address where the animal will live:________________________________________
___________________________________________________________________________________
Home Information
T
ype of Home:_______________________________________________________________________
Do you Own Home Rent Home
Landlord’s Name:_______________________________ Phone Number: ______________________
Pet Deposit Required $_______________________
** Proof of residence must be provided before adoption. PAWS Atlanta reserves the right to contact
landlord or apartment complex to verify information**
D
o you have a securely fenced yard (no gaps)? Yes No
Type of fence________________________________________________ Height __________________
Yard size is: Small Medium Large Acreage No Yard
Is the home in an Urban Rural Suburban Setting?
How long have you been at this residence? ________________________________________________
How many times have you moved in the past 5 years? _______________________________________
How many adults live in the home?__________ Children?_________ Ages of Children _____________
Does any member of the household have pet allergies? Yes No
Animal Ownership History
H
ow many dogs have you had in the past? ________________________________________________
If any, please describe what happened to each of them: ______________________________________
How many dogs have you raised from a puppy?_____________________________________________
*How did you housetrain the puppy?___________________________________________________
________________________________________________________________________________
*How did you deal with the puppy’s behavioral issues such as chewing and damaging personal
property?________________________________________________________________________
________________________________________________________________________
*Where did your puppy sleep at night?_________________________________________________
*Where did your puppy stay when alone during the day?___________________________________
What member of your family will be the primary trainer and caregiver of your new dog?
_______________
How do you plan to train your dog?_____________________________________________________
___________________________________________________________________________________
What type of behaviors will not be tolerated from your new dog?______________________________
When your puppy is fully grown, how large or small would you prefer him/her to be?_______________
Why have you chosen this particular dog to adopt?______________________________________
Please list all pets and species/breeds of animals currently living in the home:_____________________
__________________________________________________________________________________
Are your current pets spayed or neutered? Some All None
Are the animals current on their vaccinations? Yes No
Name of Veterinarian _________________________________________________________________
Have you ever had a pet for a short time (less than six months) and it didn’t work out? Yes No
If yes, please explain the circumstances and what happened to it _______________________________
Do any of your pets now live, or have lived in the past, primarily outdoors? Yes No
If yes, please describe pet and its living conditions___________________________________________
Have any of YOUR pets (not strays) been picked up by or taken to animal control? Yes No
If yes, why?_________________________________________________________________________
**PAWS Atlanta reserves the right to check county animal control records**
Current Pet Owners
W
here does your current pet stay when home alone during the day? ___________________________
Where does your current pet sleep at night?_______________________________________________
Is your current dog on heartworm prevention? Yes No
If yes, how often do you give the heartworm medication?______________________________________
What brand do you use?_______________________________________________________________
Is your current pet on flea and tick prevention? Yes No
If yes, how often do you give the preventative?______________________________________________
What brand do you use?_______________________________________________________________
Plans for this animal
W
ith this pet, how many animals will live in the household?____________________________________
Why do you want another animal? (please check all that apply)
Compani
on
P
et for Child
Pet for Family
Gift for Adult
Gift for Child
Guard Dog
Companion for Another Pet
Breeding
Not Sure
Other______________________
Are you looking for a: Male Female Either
Do you prefer a: Puppy Adult Either
Do you prefer a dog to be: Spayed/Neutered NOT Spayed/Neutered No Preference
** If you have specified that you want a puppy, please reconsider adopting an adolescent or adult dog.
The puppy stage only lasts for about six months and comes with much added responsibility. Adult
dogs are terrific too and bond just as well with their adoptive families. Older animals are the ones
that really need rescuing.**
Where will your new dog stay when alone during the day?_________________________________
Where will your new dog sleep at night? _______________________________________________
What percentage will the dog spend inside %_____________ outside%______________________
How many hours will the dog be alone each day?________________________________________
How do you plan to exercise this dog? ________________________________________________
What circumstances, do you think, justify giving a dog up?
Moving
New baby
Not getting along with other pets
Marriage/Divorce
Getting out of fence
Behavioral problems (potty training
i
ssues, separation anxiety, etc)
Dog gets too big
Children lost interest
Too time consuming
Shedding
Allergies
Aggressive behavior
Other (please explain)_____________________________________________________________
Are you prepared to provide a safe and permanent home for this dog for the next 10 to15 years
(average lifespan of a dog)? Yes No
Medical Information
W
hat do you expect annual pet care (vet care, medication, heartworm prevention, grooming, etc.) to
cost? _____________________________
What do you expect to pay in the event of a medical emergency?______________________________
How do you plan to prevent fleas and ticks? ______________________________________________
What is heartworm disease and how is it prevented? _______________________________________
If your dog later develops a medical problem that becomes expensive what would you do?
Find another home for him
Pay whatever it takes
Have him put to sleep
Give him to a rescue group or shelter
Other (please explain)_____________________________________________________________
I agree to allow a PAWS Atlanta agent to inspect my home upon appointment. Yes No
PAWS Atlanta will work with owners to keep the animal in the home as long as a safe and loving
environment can be provided there. However, if you find it absolutely necessary to relinquish the
animal, you agree to return the animal to PAWS Atlanta and bring all paperwork and identification tags
obtained, as well as any paperwork or veterinary records obtained after the adoption.
Signature________________________________________ Date__________________________
How did you hear about PAWS Atlanta? _________________________________________________
References:
P
lease list below the names and phone numbers of three friends, relatives, co-workers or neighbors.
Name Phone Number Relationship
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
With my signature below, I hereby attest that all of the information given in this application is true and
accurate to the best of my knowledge.
Signature Date
P
rint Name ________________________________________________________________________
click to sign
signature
click to edit
click to sign
signature
click to edit