Adoption Application | Dancers Bridge Dog Rescue

Applicant & Household

Tell us a bit about yourself and who's at home.

Which dog are you interested in?

Please complete this field.

Full Name

Please complete this field.

Occupation

Please complete this field.

Date of Birth

Please complete this field.

Complete Address

Please complete this field.

How long at this address? If less than two years, provide prior address also.

Please complete this field.

Phone Number

Please complete this field.

Email address

Please complete this field.

Adults in home and relationship to you.

Please complete this field.

Children and ages (enter N/A if none).

Please complete this field.

Known dog allergies (enter N/A if none).

Please complete this field.

Your Home

A little about where the dog would live.

Type of home

Single family Townhome Apartment

Other:

Please select one option.

Household description

Please select at least one option.

Do you own or rent?

Please complete this field.

Rental rules / landlord name and phone (required if renting)

Please complete this field.

Is everyone in agreement with the decision to adopt a dog?

Yes No

Please select an option.

Do you have time to provide adequate love and attention? Please describe:

Please complete this field.

When the dog goes outside, how will you supervise?

Please complete this field.

Fully fenced yard?

Yes No

Please select an option.

Pet History & Care Team

Your experience with pets, and your vet/groomer.

Current pets and types.

Please complete this field.

Vaccines current?

Please complete this field.

Spayed/neutered? If not, why?

Please complete this field.

Ever surrendered a pet? Why?

Please complete this field.

Ever had a pet euthanized? Why?

Please complete this field.

Ever lost a pet to an accident?

Please complete this field.

Past dog experience if no current pet.

Please complete this field.

How do you discipline pets and why?

Please complete this field.

Have any of your current pets ever shown aggression towards another animal?

Please complete this field.

Regular veterinarian?

Yes No N/A

Please select an option.

Most recent veterinarian name, clinic, address and phone

Please complete this field.

Veterinarian contact consent

Regular groomer?

Yes No

Please select an option.

Groomer name and phone

Please complete this field.

Groomer contact consent

Your Ideal Dog & Daily Care

Help us match you with the right dog.

Ideal dog and why.

Please complete this field.

Desired age, breed, sex and size.

Please complete this field.

Breed you would not adopt.

Please complete this field.

Willing to adopt a dog that is... (select at least one)

Please select at least one option.

Where will dog spend the day?

Please complete this field.

Where will dog spend the night?

Please complete this field.

Average hours/day alone.

Please complete this field.

Who will have primary responsibility for the dog’s daily care?

Please complete this field.

Who will have financial responsibility for this dog?

Please complete this field.

References & Agreements

Almost done — just a few commitments and your signature.

Reference 1: Name/Address/Phone/Relationship

Please complete this field.

Reference 2: Name/Address/Phone/Relationship

Please complete this field.

Agree to routine licensed-vet care?

Agree to spay/neuter if needed?

Agree to keep dog indoors?

Will this dog be crate trained?

Yes No

Please select an option.

Crate training plan

Please complete this field.

What is your plan if you were to experience a medical crisis causing you to be unable to care for the dog, either temporarily or long term?

Please complete this field.

Agree to return dog to Dancers Bridge if unable to keep?

Are you willing to let a representative of Dancers Bridge Dog Rescue, Inc. visit your home by appointment?

How did you hear about Dancers Bridge?

Please complete this field.

Interested in fostering?

I certify that this information is true and complete. This dog will reside in my home as a pet. I will provide the dog with quality dog food, plenty of fresh water, indoor shelter, affection, socialization, annual physical exams and vaccinations under the supervision of a Licensed Veterinarian.

Applicant signature (type full name)

Please complete this field.

Date

Please complete this field.