Dog Adoption Application

Are you interested in adopting one of our current or future rescues? Let us help you!

Please note that all information must be filled out before an application can be processed.

Please also allow your vet to share your medical records with us.

If you rent, we will need a copy of a letter from your landlord stating that there are no breed restrictions in your residence.

Adoption Fees:

All small breed dogs– $550

0-9 months — $450

9 months-6 years — $350

Older than 6 years — $200

The adoption fee covers basic vaccines, spay/neuter, microchip, and heartworm testing from one of our approved partners.

Name(required)

Date of Birth(required)

Address (List Street Address and City)(required)

Phone Number (required)

Email(required)

Employer(required)

List names and ages of everyone that lives in the home.(required)

Does anyone in the home have animal allergies?(required)

Is everyone in agreement with the decision to adopt a dog?(required)

If you rent, name and contact information of landlord.(required)

How many hours a day will the dog be home alone?(required)

Where will the dog be when you are not home?(required)

Where will the dog be when you are home?(required)

List All Current pets in home (Name, Sex, Age, Breed). Write 'None' if you have no pets.(required)

Are all current pets up to date on vaccines and are spayed/neutered?(required)

List all pets within the last 10 years and if they are no longer with you, why:(required)

Have you ever given up or rehomed a pet? If yes, why?(required)

Have you ever had a pet euthanized? If yes, why?(required)

Please detail any behavioral or medical issues any of your pets have had and how you dealt with them.(required)

How do your current pets react to other animals?(required)

Current veterinarian name and phone number. If you do not have a current veterinarian, please list one you have used in the past or put N/A.(required)

Do you have a specific dog in mind?(required)

Please describe, in detail, your ideal dog:(required)

Will you be hiring a trainer for your new dog?(required)

Do you have the ability to keep your new dog separated from resident pets to allow a decompression period and slow introduction to resident animals? Please explain your plan.(required)

Are you willing to adopt a dog with medical issues? Skin allergies, arthritis, food allergies?(required)

What would you do if it seemed like your dog was having a hard time adjusting to their new home?(required)

In what instance would you no longer be able to keep your dog?(required)

How long would you give your dog to settle your home, lifestyle, resident pets?(required)

Please list (2) references (name, phone number and e-mail) that Second Chances Rescue, Inc. may reach out to.(required)

Are you willing to stay in touch with Second Chances Rescue, Inc. from time to time during the dog's life to let us know how he/she is doing?(required)

Share this:

Like this: