Adoption Application Pet Adoption Pet Name Type Pet Name(s) * Pet Type Pet Type * Select Pet Type Dog Personal Information Full Name * Street Address * Zip Code * Date of Birth * Phone * Email * Employer / Occupation * Household Details Describe Residence * House Apartment Townhouse Mobile Home Condo Other Do You Own or Rent? * Own Rent Live with a Relative Do You Own or Rent Your Lot? * Own Lot Rent Lot Live with a Relative Please enter the number of Years and Months you have lived at your current locaiton. Years * Months * Please provide details about current household occupants - other than you. Number of other Occupants in your Household * just little ole' me 1 other person 2 other people 3 other people 4 other people 5 other people 6 other people 7 other people 8 other people Forgot one? + Do you have a fenced yard? * Yes No Fence Type * Select One Invisible Fence Wood Fence Vinyl / Pastic Composite Chain Link Wire Mesh Fence Height * Who Installed Your Fence? Installed it myself Professional Installer Are you prepared to walk your dog multiple times daily, in spite of weather conditions? * Yes No Do you have any family members with allergies or other health conditions that may impact the outcome of this adoption? * yes no Please explain what type of allergies they suffer from. * Pets and Vets Pets Have you ever adopted a pet from HOPE? * yes no If you currently have a dog or have had in the past, do you give them monthly heartworm preventative such as Heartguard, Sentinel, Interceptor, etc? * yes no Do you currently have or have you recently had any dogs or puppies with the Parvo or Corona Virus? * yes no How do you plan to exercise this dog each day? * Briefly explain why you can provide the best home for this animal. * Adopting an animal is a big responsibility. The animal for which you are applying will be totally dependent on you for all of its needs for the rest of its life. This includes medical care, exercise, food and training. On an annual basis, what do you think it costs to care for an animal? * If your animal requires extensive medical care, surgery, etc., in the future, are you able and willing to financially provide that for your adopted animal? * yes no Which veterinary practices/procedures do you feel are important and/or currently provide for your pets? * Annual well visits Spay/Neuter Annual vaccines as dictated by the veterinarian Annual 4DX (Heartworm and Lyme Testing) Monthly Flea/Tick Prevention Monthly Heartworm Prevention Annual Bloodwork/Pre-Anesthetic Bloodwork Any procedures recommended by the veterinarian Select All that Apply from the List Above using the Click-Drag Technique with your Mouse, or the CTRL (or CMD) Key to Click Individual Choices. Have you ever surrendered or rehomed a pet for any reason? * yes no Please explain why, and where the pet is now. * Under what circumstances would you give up a pet? * What brand and variety of food do you feed your current pets? If no current pets, what brand and variety of food do you plan to feed your new pet? * If you are approved to adopt this pet how long will this pet be alone each day? (crated or otherwise unattended) Hours * Are you able to provide a break for the dog during their time crated or alone and if so, after how many hours? * Where will this animal sleep? * Crate Cat or dog bed Family member's bed Basement Garage Outside kennel Select All that Apply from the List Above using the Click-Drag Technique with your Mouse, or the CTRL (or CMD) Key to Click Individual Choices. Please provide details about your current, and past pets. Number of Pets over the last Five Years * this is my first pet one two three four five six seven eight nine ten eleven twelve Forgot one? + Too Many? (Reset) Vets Please provide information for every veterinarian that has seen each of the pets who live in your household, regardless of whether you have financial responsibility. Please call each of these vets and give them permission to release information to us. Number of Veterinarians over the Past Five Years * don't have one yet one two three four five six seven eight Forgot one? + Too Many? (Reset) Please match your pet list to available vets. Character References Please provide following for 2 character references who do not live with you. (At least one must be a non-family member/significant other). Ideally, your references will have been in your current home, be familiar with your living situation and with your lifestyle. Personal Reference (1) First Name * Last Name * Email * Phone * Personal Reference (2) First Name * Last Name * Email * Phone * By submitting this application, you are consenting to allow a HOPE Dogs Representative to contact your veterinarian(s) to obtain pet history and medical information, and are confirming that you read and understand The HOPE Dogs adoption expectations. You are confirming that you are willing to make a life-long commitment to this animal? Additionally, you certify that all information in this application is true and understand that if the information contained herein is found to be false, your application will be voided and any pending adoption refused. Do you agree with these terms? * Agree You Can't Leave Required Fields Blank!