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Please take some time to fill out this form for an appointment to come and meet.
Alternate Phone #
What species of animal do you want to adopt?
What is the dog's listed name?
Are you adopting a pet for yourself or someone else?
Have you applied anywhere else for a pet?
If yes, where?
How did you hear about us?
Do you own any pets at the moment?
Please list your pet's names, breeds and ages.
Will your pet(s) adjust to another pet you plan to bring home?
Were any of your pets obedience trained?
Are all your pets up to date on their vaccinations?
Are all your pets spayed/neutered?
How do you feel about spaying and neutering pets?
How many pets have you owned in the last 5-10 years?
Have you ever had a pet euthanized?
Have you ever surrendered an animal to a shelter?
Please explain the situation(s)
What's your reason for adopting?
Explain "other" here
Are you familiar with heartworm and hearworm prevention?
Do you own or rent your home?
Please select your current residence type
How long have you lived at your current home?
If you rent, does the landlord allow pets?
Landlord's Phone Number
Including yourself, how many people live in the household?
Please list the ages and relationships of those who live with you
Does everyone in the household know you plan to adopt?
Is anyone in the household allergic to cats/dogs?
What is your current occupation?
How much do you think the annual vet bill will be?
What would you do if the bill went over this amount?
Will this pet be living inside or outside?
On average, about how many hours a day would your pet be alone at home?
Please explain the pet's living conditions
Do you have a complete fenced-in yard? If yes, what type?
How would you let your dog outside?
Will there be time where the dog in tied/chained up?
When would they be tied/chained up?
Will the animal spend any time in the garage?
When/Why would they spend time in the garage?
Where will the animal sleep?
Do you have a pool?
Do you have a fence around your pool?
What kind of fence is around your pool?
Please explain how you will handle housebreaking
How will you handle destructive behavior?
Will you keep your pet up to date on their vaccinations and heartworm preventatives?
Please explain why you chose "no"
Are you able to exercise the dog daily?
If yes, what method?
Have you ever been convicted of abuse or neglect of a child or animal?
If you have been convicted, please explain
What arrangements will you make for the care of your pets in case of an emergency?
If you have a pick up truck, would you allow this animal to ride in the back?
If selected "other," please explain
What reasons would you consider returning/giving up your animal?
What would you do with your animal if you had to move?
Are you willing to take care of this animal for the next 10-20 years?
If no, please explain
1st Personal Reference and Phone Number
2nd Personal Reference and Phone Number
3rd Personal Reference and Phone Number
Veterinarian Name and Phone Number
In case of a situation where I physically can not take care this animal no longer, I approve for this person to take care of this animal. (Please give us the first and last name and a phone number)
I have notified the personal references that they will be contacted by us. (We will try to contact two times before halting the process)
I have read all above and answered truthfully and nothing is misleading. I give permission to contact landlords, associations and veterinarians. I understand that Dalis to the Rescue does not gaurentee the health and temperment of the animal.
I understand that my form is good for one month after submitting. I have verified everything on this form is filled out, otherwise I understand that Dalis to the Rescue will not move forward with the screening process. I agree to check my email after submission for more information on what is next to come. If I do not see it, I will check my junk mail.