Does any member of your household have allergies or asthma? _____ If yes, please describe: ___________________
What is the activity level in your household? Mellow (quiet) ____ Moderate ___ Active (loud, busy) ____
Is someone home during the day? ___________ If so, who? _______________________________________________
How many hours will this dog be alone each day? ______________________________________________________
Where will this dog be kept when it is left alone? ________________________________________________________
Where will this dog be kept when you are home? ________________________________________________________
Where will this dog sleep at night? ___________________________________________________________________
Who will care for this dog when you are on vacation or out-of-town? _________________________________________
The annual cost associated with providing responsible care (vaccinations, medical care, boarding, supplies, etc.) to a
healthy dog is approximately $800. Do these costs present any financial problems for you? _______________________
Are you willing to potty train this dog if needed? ___________
Are you willing to take this dog to training classes if needed? ________ If yes, do you know where? _______________
Are you prepared to make a commitment of 10 to 18 years to this dog? _______________________________________
Which reasons may prompt you to relinquish, return, or rehome your dog? (check all that apply)
___ Illness ___ Allergy ___ Moving ___ Potty accidents/unable to potty train
___ Biting ___ Growling ___ Marking in house ___ Chewing/destructive behavior
___ Too active ___ Fencing jumping ___ Hides for a week ___ Digging
___ Barking ___ Non-compatible with other pets ___ None
___ Other (explain) __________________________________________________________
Have you ever had to give up a pet? ___________ If yes, when and why? _____________________________________
If your dog gets sick, what will you do? ________________________________________________________________
Do you have a current veterinarian? ____ If yes, list name and phone number: _________________________________
Have you adopted any animals from Mission Viejo Animal Services before? ___________________________________
If yes, do you still have this/those animal(s)? _________________________
Have you completed an application to adopt an animal from our shelter in the past 12 months? ____________________
If yes, which animal (name)? ____________________________________________________
Your application will be reviewed along with all others received by Animal Services personnel to ensure that the best
home possible is selected for this animal. Animals are NOT adopted solely on a first come—first served basis. The
completion of this application is not a guarantee of adoption.
Incomplete applications forms are grounds for denial of adoption
We Reserve the Right to Refuse the Adoption of any Animal
I hereby certify that the above answers are true, to the best of my knowledge, and I understand that if approved, I must
sign and abide by an Adoption Agreement.
_______________________________________
Applicant Signature
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