Adoption
Application

DOG INFORMATION

Name of the dog you are interested in adopting:

Breed:

YOUR INFORMATION

Today's Date:

Your name:

Your email:

Your street address:

Your city/town:

State: Zip:

Your cell phone:

Your home phone:

Your work phone:

Type of housing:
ApartmentCondoHouse

Do you:
RentOwn

How long at this address?

If renting, please provide landlord's name and number:

Are you planning to change residence in the near future?
YesNo

If yes, please explain:

Do you have a yard?
YesNo

If yes, is it fenced?
YesNo

Fence height:

Is it fully or partially fenced?
FullyPartially

If you do not have a fence, do you understand what a dog requires for exercise and bathroom needs?
YesNo

A representative of ECHO must perform a home visit as part of this application. Do you consent?
YesNo

Number of adults at home:

Number of children at home:

Children's ages:

Does everyone in the house agree to adopt this pet?

Does anyone have allergies?

Which family member will have the major responsibility of caring for this pet?

Do you often have people visiting your home?
YesNo

YOUR CURRENT PETS

Do you have animals now?
YesNo

Please provide the following information:
NAME BREED M/F AGE SPAYED/NEUTERED

If any of your pets are not spayed or neutered, please explain why not:

Are all pets current on vaccinations?
YesNo

Are all pets on a heartworm preventative?
YesNo

YOUR PAST PETS

Have you had other animals in the past?
YesNo

If so, what happened to them?

Have you ever had to give up an animal?
YesNo

If so, how did you do that?

CARE OF YOUR NEW DOG

Why do you want to bring a new dog into your home?

How long have you been searching for a new dog?

Where have you searched?

Why are you interested in this particular dog?

When will you be ready for your new dog?

How long will the dog be left alone during the day?

Where will the dog be kept while alone?

Do you own a crate?
YesNo

Have you ever crate trained a dog?
YesNo

Do you plan on crating your new dog?
YesNo

Will the dog be kept:
InsideOutsideBoth

How much daily exercise will you provide? Please explain:

Do you understand that your new dog may develop issues as it adjusts to its new home?
YesNo

Will you tolerate the following issues?
Housebreaking accidents YesNo
Chewing YesNo
Barking/whining YesNo

In no, please explain:

If these issues are not resolved in a reasonable amount of time, what will you do?

What do you consider a reasonable amount of time?

Would you be willing to take the dog to obedience training if needed?
YesNo

Have you ever taken a dog to obedience training before?
YesNo

If needed, how will you housetrain the dog?

Are you financially ready and willing to provide the medical care your dog will need for its lifetime?
YesNo

If something happened to you, who would care for the dog?

ADDITIONAL INFORMATION

Please provide your veterinarian's name, phone and city:

Please provide two references not living with you, name, phone and relationship:

Are you employed?
YesNo

How long at this job?

Employer name and address:

Please provide any other information you may want to include in regard to adopting this pet:

I have filled out the above information truthfully on this date

Signed:

*Please note: This application may take up to 7 business days to process. You must be 18 years of age to adopt. Incomplete applications will not be processed.