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Adoption Application Date: I am interested in adopting: Watson s Paws for the Cause Adoption Program watsonspawsforthecause@gmail.com Sponsored by Pet Medical Center www.animalhealing.net Phone: 509-545-4931 Fax: 509-545-4451 To help ensure that the animal you are interested in will fit your home, lifestyle, and expectations, and that the animal will be placed in an environment compatible with its needs, we ask for your cooperation in completely filling out this application. Please answer the questions in as much detail as possible, and return via email, fax or in person. Personal Information Name Email Age Physical Address Cell Phone Number Home Phone Number Work Phone Number Are you Employed? Employer and Position If you are not the primary income earner in your household, who is? What is their relationship to you? Primary income earner s employer and position Please list any other people, including children, who live in your residence. Please provide contact numbers of all independent adults who share your home. Name Age Relationship Contact Number Who will be the pet s primary caregiver? Are all of the people living in your household in favor of adding a new pet to the home? 1

What role will other household members have in training, discipline, playing with, and caring for a new pet? Is there anyone living in your household that is allergic to animals? Is there anyone living in your household that suffers from a chronic condition or disability that would be incompatible with living with a pet? If yes, please explain how you plan to deal with this. Is anyone in your household afraid of or unaccustomed to certain animals? If yes, please explain the situation and how you plan to deal with this. If you don t currently have children and are planning to, how will the addition of children in your life affect your desire or ability to have a pet? Living Environment What type of residence do you live in? (Circle one) Do you rent or own your home? How long have you lived at your current residence? Do you plan to move in the foreseeable future? If you move, what do you plan to do with your pets? How large is your yard? (0.25 acres etc) Is your yard fully fenced? If yes, please describe the fence height and type. If no, are you willing to fence it prior to adopting a dog? If you cannot provide a fenced yard, how do you plan to provide safe and adequate exercise for your dog? Do you have a pool? If yes, what is in place to protect the dog from drowning? Are you willing to allow us to visit your home to verify that you can offer a safe and happy living environment for this pet? If you belong to a HOA, are there any dog size limits or limit to the number or type of pets allowed? Are there any breed restrictions? Are you aware of your local Animal Control Regulations? RENTER INFORMATION If you rent, do you have the landlord s permission to have pets on the property? Please provide the landlord s name and phone number. If you rent, are there any dog size limits or limit to the number or type of pets allowed? Are there any breed restrictions? Apartment Condo Duplex House Mobile Home Other(explain) Landlord Name Landlord Phone Number 2

How many total hours per day will the pet be left alone? If you are gone for more than 4 consecutive hours, what will you do with the pet? Where will the pet spend most of the day? If you have current pets, where/how do they spend their day? Do you plan to use a dog crate? If the dog will be outside while you are gone, what kind of outdoor shelter will be provided? Please describe (doghouse/dog run, shaded or no, chained or tethered, or free range in yard) How many hours do you expect to spend with your pet each day you are working? How many hours will you spend with your pet on a day you aren t working? Will the dog have access to a dog door? Where will the pet sleep? If you have current pets, where do they sleep at night? Preferences and needs affecting choice of pet We would like to know what you are looking for in a pet companion. Please indicate the physical characteristics of your ideal dog by CIRCLING your preferred answer: AGE Puppy <8mo Young 8-18mo Adult 1.5yrs-7yrs Senior 7+ yrs No preference SIZE <10# (Toy) 11-20# (Small) 21-49# (Medium) 50#+ (Large) No preference COAT Short Medium Long Hypoallergenic No preference SEX Male Female No preference What physical or other characteristics regarding dogs are important to you? Please indicate the activity level and social interaction level you desire to have with your ideal dog by CIRCLING your preferred answer: ENERGY LEVEL Couch potato Casual walks and play Regular long walks and hikes Jogging/ Running High-level dog sports Other (explain) Please describe the activities you hope to share with your dog SOCIAL INTERACTIONS Behave well around visitors Other (explain) Visit other people s homes Little social interaction Visit public areas where other dogs are present 3

Please indicate what you are looking for from your ideal dog by CIRCLING your preferred answer: REASONS FOR WANTING A DOG Hunting Company for other Pet(s) Protection Playmate for children Companionship Therapy Gift Other (explain) Pet Ownership History Please list ALL pets you currently have in your home (include all pets that live in your residence: roommate pets, parents or other adults that have pets living in the residence, and outdoor livestock, horses, etc) NAME SPECIES & BREED AGE & SEX ARE THEY SPAYED/ NEUTERED? HOW LONG HAVE YOU HAD THEM? OWNER NAME PRIMARY VETERINARIA N Please list ANY OTHER pets you have owned (other than the ones previously listed) in the last 5 years and explain what happened to them: Please provide details about the veterinarian you plan to use for the pet you are applying for. VETERINARIAN & PRACTICE NAME ADDRESS PHONE NUMBER HOW LONG HAVE THEY BEEN YOUR VETERINARIAN? Pet-Owning Philosophies Do you plan to use a dog daycare, dog walker, boarding, or pet-sitting services? Please describe. Do you plan to train your dog? If yes, please describe your training plan (formal vs. at home, specialized vs. general) How much time do you plan to spend training your dog? Some dogs, especially puppies, may have accidents or urine mark inside the house. How 4

do you plan on dealing with this if it happens in your home? Most dogs shed and may also require regular grooming/bathing. How do you plan on dealing with a new dog s grooming/bathing needs? Even if we evaluate an adoption dog as safe with cats, they make act differently in a home and/or with different cats. What will you do if the adoption dog chases your cats, gets into their space, or annoys them in some other way? Are you willing to keep your pet up to date on vaccinations and protect them from fleas/ticks if needed? Dogs can hide illnesses well. Are you willing to provide regular routing veterinary care ( at least an annual exam, bloodwork, etc) for the rest of this pet s life? Are you willing to provide this pet with routine dental care if needed? Some dogs have been known to live up to 20 years. Are you willing to care for this pet for that long? If this pet develops an expensive or time consuming health problem (such as cancer, amputee, long-term medications, prescription food, etc), what would you do? Most of the pets we place are in good health, and we give adopters full details prior to adopting. If your rescue dog needed immediate dental, medical care, or emergency care, are you willing to provide it? Sometimes unforeseen circumstances arise. If you could no longer keep your pet(s), what would you do? Circle your answer(s). Find them another home Surrender to a private rescue Euthanize Take to the pound Other (please explain) Under what circumstances would you give up a pet that has lived with you for any length of time? Circle your answer(s). Divorce / Seperation of relationship No time to care for the pet Allergies Partner/Family dislikes the pet Digging/ destruction of property/furniture Shedding/ needs too much grooming Personal or family health problems Barking Housebreaking issues Children lose interest Escaping from home/ property/ run/ yard Expensive medical / veterinary needs New baby Difficult to train Other: Moving to a different house/ city/state Neighbor complaints None of these reasons would make me give up a pet Additional Questions About the Pet You Hope to Adopt How did you hear about this pet? 5

Why do you want to adopt this pet? Why do you feel you are a good candidate to rescue this pet? Have you considered the cost involved in owning this pet? (Regular veterinary care, exams, bloodwork, vaccinations, dental cleaning, emergency care, quality food, liability insurance, rental deposits, training, etc.) These average about $1300/year Are you financially capable of providing for this pet s needs including but not limited to: nutrition, veterinary care, and all other needs? We require all puppies and kittens who are not spayed/neutered at adoption be spayed/neutered when age appropriate. Is this something you are willing to do? It can take up to 3 business days to process an adoption application. If your application is incomplete, it can take longer than 3 business days. By signing below, I certify that the information I have given is true. I further understand that any misrepresentation of facts on this application for adoption may result in my losing the privilege of adopting a pet from Pet Medical Center of Pasco. I also understand that Pet Medical Center reserves the right to refuse any application. Signature Date Printed Name 6