Adoption Application

Preliminary Questions
Why do you want to adopt a dog from the Atlanta DogSquad?
Are you interested in a particular dog? (please name)
How would you view the retriever you rescue or adopt?	It’s simply a dog It will be my family pet It will be considered a family member
How much money would you be willing or able to spend if your retriever becomes ill or injured?	Up to $500 $500 to $1000 Whatever it takes to provide appropriate care
How would you handle temperament or obedience problems that might arise?	Punish the dog Seek professional advice from a trainer or veterinarian Return the dog to ADS
For which of the following reasons would you consider giving up your dog? (check all that apply)	Moving Divorce Excessive Barking Kids no longer want it Fights with other pets Gets too large Medical Issues Jumps Fence New Baby Financial Problems Not Housebroken Behavior Issues Allergies Messes up furniture
General Information
First Name:
Last Name:
Street:
City:
State:
Zip:
Primary Phone: (required)
Alternate phone:
Employer:
Email Address:
Confirm Email Address
Family Information
Number of Adults living in the home:
Number of children:
Child 1 Age:
Child 2 Age:
Child 3 Age:
Home and Pet’s Information
Home Type:
Do all adults work outside the home full time?	Yes No
Who will be the primary caretaker of your dog?	Myself Other
If not you, please specify:
Does anyone in your household have allergies?	Yes No
Do you have a fenced yard?	Yes No
If “no” how will you contain your dog?
If “yes” to fence how high is it?
What is the fence made of?
Do any of your pets live mostly outdoors?	Yes No
If “yes” which pets?
Where will the dog be when you are not at home?
Have you ever given up a dog?	Yes No
Will the dog be a surprise for anyone?	Yes No
How many hours a day will your dog be left alone?
Where will the dog sleep?
If you move, what will you do with your dog?
Have you ever owned a dog?	Yes No
If the dog is no longer with you, why not?
Have you previously been approved to adopt a dog?	Yes No
Name of organization that approved you:
Please list any pets living with you.
Pet 1 Name:
Pet 1 Breed:
Pet 1 Age:
Pet 1 Gender:	Male Female
Pet 1 Behavior w/Dogs:	Good Needs Work Don’t Know
Pet 1 Altered Status:	Unaltered Spayed/Neutered
Pet 2 Name:
Pet 2 Breed:
Pet 2 Age:
Pet 2 Gender:	Male Female
Pet 2 Behavior w/Dogs:	Good Needs Work Don’t Know
Pet 2 Altered Status:	Unaltered Spayed/Neutered
Reference (not a family member)
Reference Name:
Reference Street:
Reference City:
Reference State:
Reference Zip:
Reference Phone:
Alternate Reference Phone (cell):
Veterinary Information
Vet’s Name:
Vet Street Address:
Vet City:
Vet State:
Vet Zip:
Vet’s Phone:
Source Information
How did you hear about us?	Atlanta Dog Squad Website Pet Adoption Based Website (i.e. Petfinder.com) Referral Event Adopted from ADS Previously Other
If Other, please describe:

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