No Paw Left Behind

No Paw Left Behind - Canine Adoption Application

Thank you for your interest in adopting a dog through No Paw Left Behind. Please complete the following adoption application.
There are no "right" and "wrong" answers; our goal is to learn more about you and to ensure the best possible match is made for the adopter and the dog. Our decisions are made based on our knowledge of the rescued dog's background and temperament.
The application must be complete, to be considered and will be kept confidential.

Name of dog you are applying for *
Do you have any experience with this breed? *
If so please explain, and if not please explain any research or experience that you may have to help you learn about the tendencies of this breed:
Applicant Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
Age *
Are you applying to be the Primary Caretaker of the pet? Yes or No, if No please explain: *
In case of separation or divorce, who will be the caretaker of the dog? *
Employer *
Occupation and Work Schedule *
Have all members of the household agreed to adopt? *
Any children in the home? If so how many and what ages? *
Please list adult household members:
Name/relation/age/occupation *
Does anyone in your household have an allergy to animal hair or dander? *
Yes No
If Yes please explain:
Has anyone in your household been convicted of a felony? Yes/No (replying honestly, will not result in an immediate rejection of your application)
If yes, please explain: *
Would you consent to a background check? *
Yes No
Home information:
Do you live in
*
Condo Apartment House Mobile Home Townhouse Other
If Other please explain:
How long have you lived at this address? *
Do you: *
Own Rent Live with family or friends?
Please write "own" or provide the NAME and NUMBER of your rental landlord *
What are the pet restrictions in your City or County? *
What are the pet restrictions in your neighborhood or homeowners' association? *
Are there any other restictions or laws that pertain to the ownership of pets in your area? *
Do you have a pool? *
Yes No
Does it have a child-proof fence?
Do you have a private yard? *
Yes No
Is the yard fenced in? If so, by what type and what height? *
Do you agree to a home visit by an official No Paw Left Behind adoption counselor? *
Yes No
Pet History
PLEASE LIST ALL CURRENT PETS
Name/Type/Breed/Age/Health/Temperment *
Have your pets been socialized around other pets? *
Pet History
PLEASE LIST ALL PETS YOU HAVE OWNED IN THE PAST
Type/Breed/Age/Health/Temperment
PLEASE ALSO INCLUDE WHERE THE PET IS CURRENTLY (deceased, gave away, etc) *
Have you ever relinquished a pet to a rescue or shelter? If yes, where, when and why? *
Have you ever re-homed a pet? If yes, where, when and why? *
Are your pets up to date with vaccinations? (Answering honestly to the following will not result in an immediate rejection of your application) *
Yes No
Are your pets on heartworm preventative? (Answering honestly to the following will not result in an immediate rejection of your application) *
Yes No
Are your pets on flea and tick prevention? (Answering honestly to the following will not result in an immediate rejection of your application) *
Yes No
Are your pets spayed or neutered? (Answering honestly to the following will not result in an immediate rejection of your application) *
Yes No
Please list the name of your groomer: First Last
Groomer Phone Number ### - ### - ####
Please list the name of your veterinarian * First Last
The name of your vet office *
Vet Office Phone Number * ### - ### - ####
Why are you adopting a dog? *
Why did you choose this dog? *
Have you currently applied for any other dogs? *
Where will your new dog sleep? *
Where will your new dog be kept while you are home? *
Where will you new dog be kept while you are NOT home? *
What is the average length of time that your new dog will be home alone? *
How often do you go out of town? *
Who will take care of your dog when you are out of town? *
Would you adopt a dog that wasn't house broken? *
What type of training do you think is most important and how will you do that? *
What behaviors do you consider unacceptable and how will you fix them? *
How will your exercise your dog? *
What is the longest length of time you will be able to physically, financially, medically, and emotionally support this dog? *
To the best of our knowledge, we provide you with a breed and age of the dog. As your dog gets older you may notice that its features will change and that it may not be pure bred or even the age or breed that we thought it was.
Can something like this cause you to return the dog?
*
Yes No
If yes, please describe the specific circumstance.
Please describe any other reasons that you may need to return the dog to us. *
If an emergency occurred, how would you fund unexpected medical treatment? *
What will you do with your dog if you have to move? *
What would you do if you moved into a new home and you weren’t able to bring your dog? *
If you don’t have children, in what ways will your dog’s life change if you start a family? *
Do you have an emergency plan in case of a hurricane? *
Yes No
Please describe your emergency disaster plan: *
After an adoption, may we visit your home in the future? *
Yes No
Do you agree to donate the appropriate adoption fee for this pet? Dogs 5 months and older $150. Puppies younger than 5 months $200. While this donation does not cover the full medical expenses paid by the rescue, this is the amount agreed as a fair donation for all No Paw Left Behind rescues. Additional donations are greatly appreciated and go directly to help us save more lives. All donations, monetary or items, are tax deductible. *
I agree I do not agree
The donation fees required for adoption include the following services and do NOT inlcude future medical care after adoption:
Puppies will receive: two booster shots, deworming, microchip, and sterlization surgery (if old enough, if not this may be scheduled for the future). Rabies will NOT be provided for puppies under 4 months of age at adoption.
Adult dogs over 5 months will receive: two boosters, deworming, heartworm preventative (dogs over 7 months will have a heart worm test), microchip, sterilization and the rabies vaccine (NOTE this is the rabies vaccine ONLY, the county registration/tag is the responisbility of the new owner, as is required by county). *
I agree I do not agree
Do you agree that the adoption agreement includes the following medical screening and care: vaccinations appropriate to the age of the dog, heartworm testing and heartworm preventative while in foster care, flea and tick preventative while in foster care, spay and neuter, hernia repairs, teeth cleaning ONLY in cases of severe medical need to be determined by our vet, microchip, deworming, treatment for mange (sarcoptic or demodectic), treatment for ringworm and that all medical treatment records shall be disclosed once the adoption is finalized? *
I agree I do not agree
Do you agree to assume all medical costs for this pet once the adoption is finalized. No Paw Left Behind and our veterinarians disclose all known medical conditions, but medical issues may arise after adoption or due to injury? *
I agree I do not agree
Do you agree to provide speedy and quality veterinary care for your pet immediately upon the need arising? *
I agree I do not agree
Do you agree to ONLY use vet-approved brands of flea and tick preventative, and NEVER use over-the-counter discount brands that may be toxic to your new pet? (A complete list of information may be provided upon request) *
I agree I do not agree
Are you interested in any volunteer opportunities (foster, online, phone, transport, events)? If so please describe:
By typing you name into this field you are agreeing that all information in this application is truthful to the best of your ability. * First Last
Do Not Fill This Out