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Owner Surrender Form
Hypoallergenic
Yes
No
Either
Name:
*
Do you have pets?
*
Yes
No
Have you ever gave away or returned a pet? If yes, please explain.
*
Grooming preference
I don't want a dog that needs grooming often
I don't mind a dog that needs grooming
Either - does not matter
How did you hear about us?
*
aDOPTION Application
Ages of child(ren) in home
*
If yes, type and height of fence
*
Do you have a yard?
*
Yes
No
Specify:
*
House
Apartment/ Condo
Why are you looking for a new pet at this time?
*
Email:
*
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Are there children in the home
*
Yes
No
Thank you for your completing an application to adopt one of our pupz. Please be patient while we review applications.
Veterinarian name and number:
*
Size preference
*
No preference
Small
Medium
Large
Activities you would like your dog to do with you/ your family?
*
Name of dog you are applying for?
*
Phone
*
Address
*
Check one of the following
*
Own
Rent
Age Preference
*
Puppy (12 wks- 5 months)
Young ( 6 months- 1.5 years)
Adult ( over 1.5 years)
Senior
Type, breed and age of pets:
*
Occupation and work hours for each adult in the household?
*
If rent, Landlord info:
What would cause you to return this dog?
*
Aggressiveness
Destructive behavior
Not compatible with other pets
Allergies
No longer want
Moving or having a baby
Would not return under any circumstance
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