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Sam's Canine Rescue

The Care They Need. The Love They Deserve.

Adoption Application

Thank you for your interest in adopting a pet ! Below is a detailed Dog Adoption Application designed to collect essential information about potential adopters and ensure the dog is placed in a suitable and loving home. Please complete this application thoroughly. All information provided will be kept confidential and used solely for the purpose of evaluating your suitability as an adopter.

*Please note: We will contact your veterinary reference to ensure your current, or recent, pets are spayed/neutered, up to date on vaccines, and heartworm prevention.

Adoption Application

1. Personal Information

Name
Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal

2. Household Information

Type of House
Do you own or rent your home?
Please include their name, age, and relationship to you
Does anyone in your household have any allergies to animals?
Is everyone in your household aware and supportive of this adoption?

3. Dog Ownership History

Have you owned dogs and/or other pets before?
Have you ever had to rehome or surrender a dog and/or other pet?
Do you currently have any dogs and/or other pets?

4. Dog/Pet Care Environment

Where will the dog live?
Do you have a yard?
If yes, is your yard fenced in?
Are you financially prepared for the costs of dog ownership?
(food, vet care, grooming, etc.)
Do you have a preferred veterinarian?
May we contact them?

5. References

Please provide two personal references (non-family members)

6. Agreement

Check each box to agree to each of the following statements:
Second statement: