Which Dog do you wish to adopt?
Date of Birth
Spouse Work Phone
Is your residence a house or apartment?
Do you own or rent?
For Renters, Landlords phone
Number of Adult occupants in your home
Number of Child Occupants
Ages of Children
Why do you want a pet?
Type of fence and Height of fence
List previous pet and what happened to them
What pets do you have now?
Are your pets spayed/neutered?
Are they on Heartworm Preventative?
Are they current on vaccinations?
Name/company of your vet
Number of hours pet will be alone per day
Where will pet sleep?
Are you aware your pet may need Obedience training?
Are you aware your pet may need housetraining?
What will you do with your pet if you move?
Do you have time to train your pet and introduce it to your home?
Do you agree to return the animal if anything prevents you from keeping if?
Do you give your veterinarian permission to release your vet records to LL Dog Rescue?
Home checked by:
Vet check by:
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