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Underdogs Preliminary Pet Adoption Form

We hate paperwork, too.  But to help us keep track of all the people who want to give our dogs wonderful homes, we need you to fill out an adoption form.

An application does not mean you are obligated to adopt — it just lets us know you are seriously considering a dog for adoption.  Please complete all applicable fields.

Name/breed/description of Animal you wish to adopt:

Your Email Address: (required)

Your Name (required)

Street Address:
City:
State:
Zip:
County:
Home Phone:
Work:
Cell:
Date of Birth:
1. How long have you lived at the above address?

2. What type of pet are you looking for?
dog puppy other 

3. Please check the following reasons for wanting to adopt this pet:

Comments:

4. Are you or your spouse currently employed?
 yes no retired

5. Occupation and daily hours normally worked?

6. Live with your parents/relatives?
 yes no

7. Are you interested in adopting for
 yourself family someone else

8. Do you own your home or rent?
 Own Rent

9. Do you live in a:
 House Apt Condo Mobile Home Duplex/Townhouse

If renting, does your lease allow pets?
 yes no

If renting, what is your landlord’s name & phone number?

10. How many people live in your household?

11. Do all members know that you plan to adopt a pet?
 yes no

12. What are the ages of any children in your household?

13. Do you have small children as frequent visitors (i.e., grandchildren)?
 yes no

14. Does any member of the household have allergies?
 yes no

15. Will an adult be home during the day?
 yes no Part Time

16. Who will be responsible for taking care of your pet?

17. If needed, what procedures will you use for housebreaking?

18. How will you handle chewing/digging/barking/destructive behavior?

19. What type of heartworm prevention & flea protection do you plan to/currently use?

20. Are you aware of the cost for this?
 yes no

21. Have you ever adopted a pet from any Humane Society or from another shelter?
 yes no

Where?

Where is the pet now?

22. How many pets have you owned in the past five years?

Where are those pets now? (Be specific)

22. Have you ever turned in an animal to any Humane Society or to another shelter?
 yes no

When/where/why?

23. Has a dog died on your premises of distemper, parvo, or unknown causes in the last 3 months?
 yes no

24. Initial that you are aware we will be checking a national database of lists for DNA (do not adopt):

25. Do you currently own a pet?
 yes no

What type/kind?
 dog cat both other
Other:

Please list all (up to three) animals’ name(s), age, gender, and breeds:
Name:

Age:

Gender:

Breed:


Name:

Age:

Gender:

Breed:


Name:

Age:

Gender:

Breed:

26. Where do your pets live?
 outdoors indoors

27. Are their shots up to date?
 yes no

28. Are they spayed or neutered?
 yes no

29. Are you aware that your new pet has been spayed or neutered by Underdogs?
 yes no

30. What is the name & phone number of your veterinarian or vet clinic?

31. Are you willing to go to the expense and trouble of taking your new pet to a veterinarian for full preventive and medical care at least once a year?
 yes no

32. Where will your new pet live?
 inside outside

33. Where will he or she sleep?

34. Is there a yard available?
 yes no

35. Is the yard completely fenced?
 yes no

36. Is there shade?
 yes no

37. What do you plan to do with your pet when you go on vacation?

38. If you have to move, what would you do with the pet?

39. Would you allow an authorized representative of UnderDogs to inspect the premises where the pet will be kept?
 yes no

Comments (any answers you’d like to clarify, why you would like a pet, why you like this pet, anything you would like to add):

We at UnderDogs thank you for your interest in our animals and for your help in making successful adoptions by taking the time to complete this application.

(You can also fax to 850-226-4496 or email SaveUnderDogs@aol.com)nd-