We get too many applications that do not have a vets name, location, and phone number included. THIS IS REQUIRED! If you rent, your landlords name and phone number are required also. We DO NOT look up phone numbers due to our limited time to spend on researching this information.

By submitting the application, you are giving Fuzzy Friends Rescue permission to investigate and confirm the information that you provide. All forms become the property of Fuzzy Friends Rescue upon submission.

If you do not have a current vet, you must include the vets name and phone number that you are going to use. This is so we can do a post adoption follow up on the pet you are adopting.

If any information is left blank, your application will not be reviewed.

If you are approved to adopt the pet you are applying for, this will become a part of your permanent record.

Please understand that not all families and dogs/cats are compatible. Every effort is made to match traits exhibited by a dog/cat with characteristics, which you desire in a pet. Our goal is to ensure the welfare of the animal only by placements in the best possible home. Fuzzy Friends Rescue has the right to deny adoption of ANY animal to ANYONE for ANY reason.

In order to be considered as an adopter today, you must:

• Be 21 years or older
• Have a valid driver’s license or other photo ID and identification with your present address
• Be able to verify that you can have a pet where you live (if renting or if living with parents or someone else) and
• Be willing and able to spend the time and money necessary to provide the proper care for a pet, including food, shelter, veterinary care, grooming and training, for the lifetime of the animal you adopt.

Date:

DL # (Must provide a copy to FFR):

Name:

Address:

City: State: Zip Code:

Home Phone Number: Work Phone Number:

Cell Phone Number: Best Time to Call

Email address:

Occupation:

Spouse's occupation (if applicable)

Check all that apply: Student Employed Retired

Family Members/Guests With You Today

Description of Residence:
House
Apartment
Mobile Home
Duplex
Condo
Other (please describe)

Do you:	Rent	Property Owner Name: Phone:
	Own	Length of time at current residence:

Do you live with parents?YesNo

Do you live with a non-relative?YesNo

If you rent:
Does your landlord allow pets? YesNo
Is a pet deposit required? YesNo
Do you have a size/weight limit? If so, what is that limit?
Can proof of deposit be obtained from your landlord? YesNo
Upon approval of application, it is required that the pet deposit be paid prior to the pet being released into your care.

Number of people in household: Adults: Children:
Ages of Children:
If you do not have children, do any children/grandchildren, etc. visit your home frequently? (if so, please elaborate)

Does anyone living in the household have allergies to:
Dogs
Cats
Neither

Does anyone living in the household have asthma? YesNo

Are you willing to let a representative of Fuzzy Friends Rescue visit your home by appointment?YesNo
If no, why not?

Who will support this dog financially?:
Myself
Spouse
Friend
Family
Parents

Where will you keep this dog?: (Check all that apply)
Fenced yard
Tied outside
Loose outside
Kennel/Run
Garage
Patio/balcony
Inside home
Other

This dog will be kept: Mostly Inside Mostly Outside Totally Inside Totally Outside with shelter As It Prefers

Does your house have:
Pool?
Doggy Door?
Fenced Yard? Type/Height of Fence

Where will you keep this dog at night?

Where will you keep this dog when you are not home?

How many hours, on average, will this dog spend alone?

If applying for an outside dog, do you have a doghouse? YesNo

If you do not have a fence, how will you handle this dog's exercise and toilet duties?

What do you consider valid reasons for giving up a pet? (Mark all that apply)
Moving
Fleas
Destructive
Grew too big
Digging
Chewing
Vet Bills
Unable to house train
Having a Baby
Barking too little/too much
Litter Box Problems
Too rough with children
Other (please elaborate)

Will dog be family pet for:
Family pet for children
Companion to adult(s)
Hunting Dog
Guard Dog
Companion for other dog
Gift for someone else
Other

How long do you expect to keep this pet?

If you had to move or lost your job, what would you do with this pet?

What qualities are you looking for in a pet that you would like to adopt? Be specific (very active vs. couch potato, etc.) so that we can make the best match possible.

Do you know about crate training?
If dog is not housebroken, how will you deal with housetraining issues?

Have you had experience with obedience problems?

If this dog develops behavior problems (chewing, etc.), what measures would you take?

If this puppy gets larger than you expected, what would you do?

Dogs often live in excess of 10 years, are you prepared to assume responsibility for that long?YesNo

Pet Ownership History

Have you ever adopted from us before? YesNo
If so, when/what?

Have you ever had to give up a pet? If so, why and to whom?

Are all of the pets in your household current on their vaccinations? YesNo

Are all cats in the household tested for Feline Leukemia/FIV? YesNo

Are all dog you have now on heartworm prevention? If so, what kind of heartworm preventative do you use, and what is the date of last heartworm preventative given?

Flea and tick prevention used in your home? If so, what brand?

Have any pets in your household been diagnosed with the following infectious diseases or conditions?
Heartworms
Distemper
Parvovirus

Please list all pets currently living at your address (List Species, name of pet, age of pet, Gender, length of ownership, and if they are Spayed/Neutered)

Please list any previous pets owned in the last 5 years that are no longer with you (List Species, name of pet, age of pet, Gender, length of ownership, and if they were Spayed/Neutered)

What happened to the above listed pets that are no longer with you? (Please explain in detail)

List all Veterinary Clinics used in the past 5 years (Please provide vet's name, address, and phone number)

Please describe the extent of care that you are willing to provide should your dog have special medical needs now or later in life:

Are you familiar with:
Parvovirus
Distemper
Bordatella
Rabies
Parasites
Heartworms

Please describe what you know about the causes and prevention of heartworms:

My Current Veterinarian is
Located at
And Can be reached at this phone number:

Release for Veterinary Reference: (to be completed by potential adopter)

I, (name), hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals to Fuzzy Friends Rescue, including the pet I'm adopting at this time for follow-up purposes in the case of existing conditions or simply well check and heartworm prevention status.

When/why was your last vet visit?

How did you hear about Fuzzy Friends Rescue? (please be specific) May we thank them for the referral?