Rehoming Application

* indicates required field

Write N/A if the field does not apply.

Where did you hear about us?*

Your dog's name?*

How old is your dog?

How much does your dog weigh?

What is the Breed / Mix of your dog?*

Why are you looking for a new home for your dog?*

First Name:*

Last Name:*

Spouse's name

Email:*

Secondary Email:

Street Address (NO PO BOX)*

City, State, Zip*

Telephone Number:*

Alternate Telephone:

Are you 21 years of age or older?*

Yes
No

Who is your current veterinarian?*

Current Vet's Street Address:*

Vet's City, State, Zip*

Current Vet's phone number:*

Your dog is used to:*

(CRTL and click for ALL that apply)

Your dog is:*

(CRTL and click for ALL that apply)

When you are in the house, where is the dog allowed to be?*

When no one is in the house, where do you leave the dog?*

Does your dog have any current medical problems?*

(Please describe and note if treatment has been attempted.)

Has your dog had any previous medical problems?*

(Please describe and note what treatment was used.)

Does your dog have any current behavioral/emotional problems?*

(Please note what has been tried in an attempt to address the problem.)

Has your dog had any past behavioral or emotional problems?*

(Was the issue resolved and how?)

Has your dog ever bitten another dog?*

(If YES, please describe the situation and / or circumstances in detail.)

Has your dog ever bitten a human (adult or child)?*

(If YES, please describe the situation and circumstances in detail.)

Is your dog an "Escape Artist"?*

Yes
No

(Meaning will your dog run out the door or run off if given the chance?)

Does your dog have any obedience training?*

(If YES, please describe)

Where does your dog sleep?*

By submitting the Rehoming Application, I am certifying that:

I am at least 21 years of age.
I am the legal owner and the responsible person for the care and well-being of this dog.

The above application MUST be fully completed to be accepted!

CAPTCHA Code:*

Please notice

When you submit your application you will receive a success page. If you are redirected to the top of this page you need to check for an overlooked error and correct it before the application will be sent.

After completing this form, please also work on the biography for your dog. Here is the accepted format for a dog biography

Rehoming Application

By submitting the Rehoming Application, I am certifying that:

Adoptable Dogs Gallery