Adoption Application

All Applicants must read Take Paws Rescue's Adoption Process and Adoption FAQs PRIOR to completing an Adoption Application. Applicants under the age of 21 and/or third party Applicants will NOT be considered.

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone*

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Did you submit the $10 application fee donation prior to completing the application?*

If you did submit a $10 donation / application fee, what is the name and/or email address on the payment and the form of payment used? *

Age of Applicant*

Occupation*

Co-Applicant Name if applicable

Age of Co-Applicant if applicable

Co-Applicant's Occupation if applicable

Age of all other residents in the home*

Who is the dog primarily for? (Adult, Child, Elderly)*

Does anyone in your household have allergies?*

If Yes, to what allergens?

Please tell us a little of your lifestyle and your family including any special activities in which your dog would be included. If you have any special requirements or requests for a dog, please let us know so that we can more carefully match a dog to your lifestyle*

Please tell us why you want a dog*

Is there a specific animal from our website that you are interested in?*

If so, which one?

Why are you interested in this particular dog?

Is this the only dog you are interested in? If there are other dogs with our rescue that you are interested in, please indicate their names here:*

Age Desired Example: Any / Specific Age / Young / Senior (8 yrs+) *

Gender preference*

What size dogs are you interested in adopting (when full-grown)?

Small (25 lbs. and under)	Medium (26-60 lbs.)
Large (61-100 lbs.)	X-Large (Over 100 pounds)

Desired Activity Level*

How soon are you looking to adopt?

ASAP	Next Few Months
Not Sure Yet

Do you have any upcoming vacations, work-trips, or other obligations in the near future? If so, please provide the dates:*

Would you consider adopting a Heartworm positive dog?*

Would you consider one with Special Needs? Such as one who requires medication for a permanent but controlled condition*

Would you consider adopting a bonded pair of adult dogs?*

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Do you own, rent or other living arrangement?*

If you rent, please provide landlord's name and phone number:

Do you have the permission of your landlord to have a dog? If yes, up to what size and/or excluded breeds?

Type of Dwelling?*

How long have you lived at your current address?

Where will your dog live? Inside or outside? *

How long daily will the dog be left alone (without humans)?*

Where will the dog stay when you are away from the house (work, school, errands, etc...)? *

Where will the dog sleep at night? *

Is your yard fenced?*

Type of fence?

If you do not have a fence, will you install one?

Approximate size of dog's yard area*

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Please list all current pets in the household (include names, species/breed, age):

Please list all prior pets you have owned in the past five years and explain what happened to them if you no longer have them. If deceased, please provide cause of death and age at death. *

Past pets continued: *

Are all of the current dogs and/or cats in the home spayed or neutered?*

Are all of the current pets in the home up-to-date on vet recommended vaccinations?*

Are all the current dogs in the home on Heartworm Preventative?*

What do you know about Heartworms?*

Where do you currently purchase Heartworm prevention from? If you don't currently purchase it, would you and if so from where?*

Have you ever or would you ever, elect to have cosmetic surgery performed a pet, such as ear cropping, tail docking, or cat declawing? If so, under what circumstances?*

Have you ever sold a pet, rehomed a pet, given away a pet, or surrendered a pet to a shelter/rescue group? If yes, please specify why and how long ago?*

Please provide the full name, address and phone number of your current veterinarian*

Please identify all other veterinarians that you have used within the last five years including name, address and phone number.*

If your vet records are under an alternate name than the primary applicant on the application (spouse, maiden name, ex-spouse, parent, roommate, etc.) please list the name or names here. If we cannot obtain vet records based on the information provided, your application will be declined without further notification. IF you have animals in the home that you do not own (ex: roommate has a dog) you must provide their vet information. We must verify ALL pets in the home are spayed/neutered and up-to-date on vaccinations for the safety of the animals in the care of Take Paws Rescue. *

Will your dog receive formal obedience training? *

Please describe in detail how you plan to train your adopted dog. What methods do you plan to use?*

Please describe how you plan to discipline your adopted dog.*

Most dogs are active, and many are highly active. All dogs need a lot of time, attention, and exercise. We cannot always accurately predict how much daily activity and attention a dog/puppy will need in its future home. Not having time, space, or money to meet a dog's needs are the top reasons dogs are returned or rehomed. Can you explain in detail how you plan to meet your dog's needs for exercise and mental stimulation on a daily basis?*

What would you do if you are having difficulty meeting the dog's needs?*

Please identify any behaviors or situations that might cause you to return the dog.*

Who will care for, train and exercise the dog?*

Does everyone in your household share your interest in adopting a dog?*

How much do you think it will cost you to care for your dog annually? (Food, Training, Vet Care, Medication, Boarding, Toys, Treats, Grooming, Supplies...)*

Take Paws Rescue is a foster-based rescue based in New Orleans, but have adopters all over the country. If you are interested in adopting from us but are located out-of-state, please indicate your plan (if you are selected) to transport the dog/puppy back to your home.

What sort of steps would you take to make sure you could take your dog with you if you had to move or evacuate your home (ex: hurricane, natural disaster)?*

Have you, or any member of your family/household been cited for leash law violations or cruelty to animals in the past?*

If YES, please specify

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If you were referred to Take Paws Rescue by a previous adopter or volunteer, please provide their name(s):

How did you hear about Take Paws Rescue and/or the animal you are applying for?

I have reviewed my application and certify that everything is accurate to my knowledge. I understand that if ANY information is found to be FALSE or INCOMPLETE at ANY time during the application process, my application will be DENIED without notification. *

I have read and understand Take Paw Rescue's Adoption Process and FAQs posted on their website at https://www.takepawsrescue.org/faq *

I understand that all animals adopted through Take Paws Rescue are required to be spayed/neutered prior to adoption or at 6 months of age if adopted as a puppy. I understand there are NO EXCEPTIONS. *

I understand that while the Take Paws Rescue Adoption Coordinators may contact me via phone or e-mail, further contact is NOT guaranteed, nor is placement of requested dog or any future dog.*

I accept that the Take Paws Rescue Adoption Coordinators have the right to REFUSE my application for ANY REASON and WITHOUT notification and WITHOUT explanation. *

I agree to allow the Take Paws Rescue Adoption Coordinators to obtain any pertinent information regarding my home situation and care of animals. This includes, but is not limited to, obtaining a vet reference from current/past veterinarians, and doing a home visit and inspection with the applicant and household members. I consent for any vets (current or past) identified on the application to release information and records regarding current or past animals to Take Paws and their volunteers. *

I understand that ALL Household members, including children, must be present during the home check evaluation, if one is scheduled.*

You will be required to have an in-person home check or facetime home check done prior to application approval. What are the best days of week & times to schedule a home visit?*

Other information you'd like us to consider:

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In the event that your health deteriorates and you are unable to care for your dog, do you have someone designated to care for your dog? If so, have you discussed this with them?

Please provide the name, relationship and phone number of 2 references that do not live in your household: *

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