Dog Adoption Application

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Thanks for your help!

Our adoption process starts with you filing an adoption application. You can complete and submit the form below.

When we see you in person, we will need your signature on the application form.
An * indicates required information. The form will not send until all * required fields have information.
If you do not see a ‘Thank You’ page after pressing ‘Send’ – it means the form did not send.
In that case, please scroll up to the top of the form to see the Error Message and Instructions.
Thanks!

If you have any questions please Contact Us.

Dog Adoption Application Form

Please Note:
This form has Required Fields marked with a ' * '.
The form will not send if a Required Field is missing information.
If you do not see a 'Thank You' screen after completing the form and pressing the 'Send' button - it means the form did not send. If you do not see a 'Thank You' page after pressing 'Send', scroll up to the top of the form to view an Error Notice and Instructions. Thank you!
Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Address
Street Address Address Line 2 City State ZIP Code
How long at current address? Years/Months*
Do you live in:*
- Home
- Apartment
- Mobile Home
- Live with Parents
Home Phone*
Mobile*
Your Email*
Who is your landlord?
If renting, do you have a copy of your Pet Addendum?
- Yes
- No
If renting or leasing, phone number of landlord.
Employer*
Employer Contact Email
DOG ADOPTION INFO
Dog Gender Preference
- Male
- Female
- No Preference
If you have seen a dog our website that you would like to meet, list the name of dog.
Approximate age of animal.
Type of pet personality wanted.
Is this your 1st experience with a dog?*
- Yes
- No
What made you decide you wanted to adopt a pet and how long have you been looking?*
What is the primary reason you want to adopt?*
- Companion for self / family / pet
- Gift
- Other
Have you ever adopted an animal before?*
- Yes
- No
If 'Yes' - where did you adopt?
Have you ever given up an animal for adoption?*
- Yes
- No
If 'Yes' - Where did you give up the animal for adoption?
What percentage of time will your pet be:
Indoors*
Outdoors*
Do you have a doggie door?
- Yes
- No
HOME ENVIRONMENT
Number of people regularly in your home:
Number of Adults in Household:*
Ages of Adults:*
Number of Children in Household:*
Ages of Children:*
Example: 4,6,12
Is anyone allergic to dogs in your house?*
- Yes
- No
If Yes, please give details:
Who will be responsible for the dog?*
Will there be any regular extended periods of time your dog will be alone (other than normal work hours)?*
- Yes
- No
If Yes, please describe what arrangements will be made for the dog's regular and emergency care:
Name of current veterinarian or clinic:
What brand of food will you provide for your pet?
Can you keep your new dog isolated for at least a week from your existing pets?*
- Yes
- No
Where will you keep the new dog isolated?*
CURRENT PETS IN HOUSEHOLD - DOGS
Do you currently own one or more dogs?*
- Yes
- No
How many dogs currently in the household?
Please list the ages and breeds of dogs (separated by a comma - if more than one dog)
Is each dog you own current on their shots?
- Yes
- No
Are all of your dogs spayed or neutered?
- Yes
- No
If your dogs (or dog) are not spayed or neutered - why not?
Please give percentage of time your current dogs (or dog) are kept inside and outside.
Indoor %
Outdoor %
CURRENT PETS IN HOUSEHOLD - CATS
Do you currently own one or more cats?
- Yes
- No
How many cats currently in the household?
Please list the ages of cats (separated by a comma - if more than one cat)
Is each cat you own current on their shots?
- Yes
- No
Are all of your cats spayed or neutered?
- Yes
- No
If your cats (or cat) are not spayed or neutered - why not?
Please give percentage of time your current cats (or cat) are kept inside and outside.
Indoor %
Outdoor %
DOG ADOPTERS:
Are you familiar with leash/licensing laws in your community?
- Yes
- No
Are you willing to take your dog to training?
- Yes
- No
How will you confine your dog? (click all that apply)
- Leash
- In the house
- Chain
- Dog Run
- Crate
- Yard
Do you have a fenced yard?
- Yes
- No
Type of fence:
- Wood
- Chain Link
- Other
Height of fence (in feet):
Are you willing to housebreak your dog?
- Yes
- No
Have you crate trained a dog previously?
- Yes
- No
Are you familiar with Heartworm Disease?
- Yes
- No
Are your current dogs on heartworm preventative?
- Yes
- No
Please click on ALL the behaviors you are unwilling or unable to deal with, tolerate or work through until resolved:
- Eliminating in the house
- Mouthiness
- Destructive chewing
- Aggression toward other animals
- Barking
- Jumping Up
- Separation anxiety
- Shedding
- Escaping
- Rowdiness
- Digging
List any other behaviors you are unwilling or unable to deal with, tolerate or work through until resolved:
Are you familiar with Canine Distemper?
- Yes
- No
Are you familiar with the canine disease Parvovirus?
- Yes
- No
Please tell us how you heard about us?
- PetSmart Customer
- I am a Previous Adopter
- Petfinder / PetArk search
- Google Search
If you were referred to us - please let us know who referred you?
I certify that the information entered above is true and that false information may result in nullifying this adoption.

I also authorize my veterinarian to release my veterinary records on my personal pets to Lost Paws Rescue of Texas.

I authorize Lost Paws Rescue of Texas to contact me by phone, email or in person at the information released in this application.

I agree to pay the adoption fee, as required. I understand that the Lost Paws Rescue of Texas adoption fees are applied to defray the costs of medical care and boarding for our adoptable dogs and cats. We are an all volunteer organization and 100% of donations and adoption fees go towards the well-being and adoption of animals in our care.

I agree to all provisions of the Lost Paws Rescue of Texas contract. I acknowledge that if I break the contract terms - I may be subject to criminal and civil prosecution.
Signature*
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Please Note: If you do not see a 'Thank You' page after pressing 'Send' - it means your form has not sent! In that case, please scroll up to the top of the form to view an Error Notice and Instructions. Thank you!

Dog Adoption Application

Dog Adoption Application Form

Lost Paws Rescue of Texas Happy Adopters – Oliver