Blue Dog Rescue, Inc. 2541 S I-H 35, #200-328, Round Rock, TX 78664-7357 (512) 689-6328 www.bluedogrescue.com ADOPTION APPLICATION
Date: Dog’s Name:
Applicant Information
Applicant Name: Age: Occupation:
Email:
Home Phone Number: Work Phone Number: Cell Phone Number:
Address: City: State: Zip Code:
This address is a: Apartment House Mobile Home Townhouse/Condo Other
Will the animal reside at this address? Yes No
Do you own or rent your home? Own Rent If renting, how much is your pet deposit? If renting, please note we will require proof that this pet will be permitted in your residence.
How many adults in the household?
How many children in the household? Ages of children:
Pet History
Have you ever previously visited with or adopted a dog from Blue Dog Rescue? Yes No If yes, please list name of dog and foster person:
Have you ever moved from one residence to another without taking your pet? Yes No If yes, please explain:
Current Pet Information
Do you currently have pets? Yes No
If yes, please provide the following information about each of the animal companions currently in your home:
Pet #1: Dog/cat/other? Breed: Spayed/Neutered? Yes No
Where you got him/her: How long you've had him/her:
Pet #2: Dog/cat/other? Breed: Spayed/Neutered? Yes No
Pet #3: Dog/cat/other? Breed: Spayed/Neutered? Yes No
Pet #4: Dog/cat/other? Breed: Spayed/Neutered? Yes No
Past Pets
For each of the animal companions you have had as an adult , please provide the following information:
Where you got him/her: How long you had him/her:
What happened to this pet:
Specific Dog Adoption Information
Why do you want to adopt a rescue dog?
What interests you in this animal specifically?
Does every member of the household want to adopt this animal? Yes No If no, please explain:
This animal will be housed: Indoors Only Outdoors Only Indoor/Outdoor
Where will this animal be kept during the day? At night?
Where will the animal sleep? Outside Garage/Basement/Laundry Room Kitchen Bedroom Other Living Area Other:
Do you plan to use a crate with this dog? Yes No
Please list three examples of behaviors that, in your household, would result in a correction for the dog:
How do you plan to correct this dog when he/she does something wrong?
Excluding emergency care, please estimate what you expect to spend annually on food, routine vet care, heartworm/flea prevention, toys, treats, bedding, training, and equipment for this dog: under $100 $100-$500 $500-$1000 $1000-$2000 over $2000
Do you have a fenced yard? Yes No If yes, what is fence type and height?
Hours per day family is away from home: Days per year of overnight travel:
Will the dog travel with you? Always Never Sometimes If not always, where will the dog stay when you are traveling?
Does anyone in your household have allergies to animals?
Who will be the primary caregiver? Alternate Caregiver:
If something should happen to you, who would take responsibility for this animal?
I plan to engage in the following activities with this dog on a daily basis: (check all that apply) Walking/Hiking Running Watching TV Grooming Playing Fetch Yard Work Obedience Training Doggy Parks Car Rides Doggy Day Care Other:
I plan to engage in the following activities with this dog on a weekly basis: (check all that apply) Walking/Hiking Running Watching TV Grooming Playing Fetch Yard Work Obedience Training Doggy Parks Car Rides Doggy Day Care Other:
Are you familiar with heartworm prevention? Yes No
Vet/Home Visit Information
What is your veterinarian’s name? Clinic:
Please type your initials here to indicate your consent for a Blue Dog representative to verify current/past pet information with your veterinarian:
Would you object to a home visit by one of our representatives? Yes No Please note that our policy is to complete a home visit prior to adoption.
How did you hear about Blue Dog?
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