Fill out this form below:

Happy Paws Dog Information

Name of dog:



Adopter's Home Information


Street Address




Home #

Work #

Cell #

Email (preffered method of contact)

Type of housing

Do you currently

How long have you lived there?

If you are renting, please provide your landlord's name and number

Are planning to move in the ner future?

If yes, please explain:

Do you have a yard?

Is it fenced in?

If yes, fence height:

Is it fully or partially fenced?

If no, do you understand what a dog requires for exercise and bathroom needs?

Would you mind if a representative of Happy Paws Rescue, Inc. came to your home to visit?

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?

Adopter's Home Information

Do you have animals now?


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

Are they current on vaccinations?

Are they on heartworm preventative?

Past Pets

Have you had other animals in the past?

If so, what happened to them?

Have you ever had to give up an animal?

If yes, 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 with the dog be left alone during the day?

Where will the dog be kept?

HDo you own a crate?

Have you ever crate trained a dog?

Do you plan to crate train?

Will the dog be kept
 inside outside

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?
 Yes No

Will you tolerate the following issues: Housebreaking accidents?  Yes No Chewing?  Yes No Barking/Whining?  Yes No

If 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 for obedience training if needed?

Have you ever taken a dog to obedience training before?

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?
 Yes No

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


Veterinarian's Name: Phone: City:

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