Dog Adoption

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If you want to send your pre-adoption application online, fill in the spaces below.

Thank you for your interest in adopting one of our wonderful rescue animals. Please complete the following information, which will help ensure the best match for you and your new pet. After completion, please return to a HSS volunteer for careful review and to answer any questions s/he may have for you regarding your application. Note – HSS has as its primary concern the well-being of our animals. We are seeking the best match between each pet and prospective adoptive family; the completion of this application does NOT guarantee approval of the adoption. In cases where several people are interested in the same pet, we will select the home that is best suited for the pet -regardless of the order in which the applications were received. Many variables are considered in this important decision and the final determination will be based on our best judgment and experience. Incomplete applications will not be considered. We thank you in advance for your cooperation, understanding, and patience during this process.


    Animal Information/

    Name of the animal you are interested in adopting?

    Adopter's information

    Home Phone:
    Cell Phone:
    Will the animal live at the address listed above? yesno
    Are you 18 years of age or older? yesno
    Do you or your spouse have jobs that require relocation? yesno
    If so, how often do you relocate?
    If you relocate, what will you do with your pets?
    Do you mind if we check with your veterinarian(s)?
    Veterinarian Name






    Any additional information:

    Reasons for adopting this pet:
    companion for selfcompanion for current petfamily petgetting pet for a friendgetting pet for a relativehunting dogguard dogoutside dogother

    Where will your pet live?
    Where will your new pet stay when left home alone?
    free run of home insidesingle roombasement or garagecratedog pen outsidefenced yardchained outsidetied to run
    Where will your new pet sleep at night?
    free run of home insidesingle roombasement or garagecratedog pen outsidefenced yardchained outsidetied to run
    Will there be an adult home during the day? If no, how many hours will the pet be alone during the day?
    Do you understand the proper care of your pet which includes making kennel reservations when you plan a family vacation?
    Are you aware of the proper way to introduce a new animal into a household with an existing pet?
    Please explain:

    Will you be able to keep this new pet on a monthly heartworm, flea and tick prevention?

    Will you permit a HSS representative to visit you in your home prior to and after adoption?
    List the most convenient days and times for you:

    Have you ever adopted a pet from HSS or another humane society? YesNo
    Please explain:

    What is the total number of pets in your home?

    Where do your animals live?

    List all the pets including name, breed, color, age.

    Are all the vaccinations current?
    Are they all spayed or neutered?
    Are you employed? yesno
    If so, where?
    For How Long?
    Work Number:
    Do you live in: HouseCondoApartmentTownhouseMobile Home
    Do you: OwnRentLive with parentsLive with roomates
    If you live in an apartment complex: name of complex?
    Please provide the name of management:
    Number of management:
    Are you aware of the animal laws in the community? YesNo
    How many adults live in your household?
    Do they all want a dog? yesno
    Who will be the primary caregiver of the dog?
    How many children?
    Do you or anyone in the family have allergies to dogs ? YesNo
    What is the size of your yard?
    1/4 acre1/2 acre3/4 acre1 acre
    What size fence do you have? (Length Width Height)

    What type of material is the fence made of?

    How busy is the street in which the home is located?
    busyslight trafficcountry (off main road)residential neighborhood
    Please give history of previously owned pets and what happened to them.
    Did any of your pets die of:
    old agesudden deathparvo/distemperheartworms
    Please explain:

    Reasons for given away:
    developed allergyrelocatedgave to friend/relativeskids lost interestgot married/divorcedsurrendered to shelternew babyspouse/partner didn't like petfinancial hardship
    pet was stolenran awayput to sleep
    How big do you think the puppy you are adopting will be as an adult?
    smallmediumlargedon't know
    What activity level do you think this pet will have once he/she is an adult?
    Who will be responsible for spending the time to train the puppy?

    How will your pet be cared for when you leave town?

    List some problems associated with raising a puppy:

    What behaviors will you not be willing to tolerate from a pet?

    What will you do to correct the behaviors you have just listed?

    Please check and sign by each statement

    I understand that a dog may live up to 15+ years and I am prepared for this lifelong commitment.
    I understand that it may take a month or longer for this pet to adjust to its new home and I am prepared to allow this much time.
    I understand that young children (< 8 y.o.) should not be left unsupervised with any animal.
    I understand that I must puppy/dog-proof my home to ensure the safety of my pet.
    I agree to provide fresh food and water, and a shelter for inclement weather if my pet will be outside for hours while I am away.
    I agree that that I will provide for annual vaccinations, regular heartworm prevention medication, monthly flea/tick prevention medication, de-worm as necessary, and provide regular grooming for my pet. Failure to do so will adversely affect the health of the animal.
    I understand that I must visit the veterinarian if my pet acts unusual; I must also schedule an annual exam BEFORE the rabies vaccine and other vaccines expire.
    I understand that if my pet is not provided with the appropriate exercise, attention, and affection, s/he may experience loneliness, boredom, frustration, depression, etc which may translate into your pet's destructive behavior such as inappropriate chewing, barking, digging, aggression, etc.
    ACKNOWLEDGEMENT – I hereby certify that all the information that I provided is true and correct. Further, I hereby authorize HSS to verify any and all information provided for purposes of adoption. I understand that any misrepresentation or untruthfulness will result in my application being denied.
    Adopter's Signature