Adoption Application - Pooch Match

This is not a test and completion of this document does not imply a guarantee of approval for adoption of any Pooch Match animal. Please answer each question completely. Do not skip any questions. If there are questions that do not apply, please enter not applicable (N/A). Completion of the application, in entirety, is required in order for us to review your application for approval/denial.

Name of the dog(s) you are interested in (if multiple, please specify ‘and’ / ‘or’):*

Your Name*

First Last

Age*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Occupation*

Employer*

Years with Employer*

Breed of dog you seek*

Age of dog you seek*

What sex are you looking for?*

Size of dog you seek*

Select All
Toy (under 10 lbs)
Small (10 - 25 lbs)
Medium (25 - 50 lbs)
Large (50 - 80 lbs)

Activity Level Preference*

How much physical & mental stimulation do you want to give your dog?

Low (house pet)
Medium (weekly walks)
High (daily walks/jogging pal)

Please describe the characteristics you find important in the dog you adopt:*

Please describe the characteristics you DO NOT want in the dog you adopt:*

What will you do if your dog has some unwanted characteristics?*

How sociable do you want your dog to be with strangers?*

Are you looking for a dog who is comfortable in a social setting (dog parks, dog beaches)?*

Yes
No
Would prefer it, but not necessary
No preference

Please describe the energy/activity level of your household, in general:*

Do you own or rent?*

Own
Rent

Type of residence*

House
Apartment
Condominium

Do you have permission from your landlord to have a dog/puppy?*

Yes
No

Landlord's Name*

First Last

Landlord's Phone*

Do you live in a two-story home or in a second-floor apartment?*

Yes
No

Is there a patio?*

Yes
No

Is the patio enclosed?*

Yes
No

How is the patio enclosed?*

How high is the enclosure of your patio?*

Are there any gaps at the bottom of the enclosure?*

Yes
No

How large are the gaps?*

Is there a balcony?*

Yes
No

How is the balcony enclosed?*

How high is the railing of your balcony?*

Are there any gaps at the bottom of the railing?*

Yes
No

How large are the gaps?*

Do you share your yard with anyone else?*

Yes
No

Do you have a fenced yard?*

Yes
No

Where and how often do you plan to take your dog to potty?*

What type of fencing do you have?*

How high is your fence (at the lowest point)?*

How high is your gate?*

Do you have a pool?*

Yes
No

Is there a fence around the pool?*

Yes
No

How many adults in your household?*

Please list their names, ages and occupations:*

Name	Age	Occupation

Does everyone in your household want to adopt?*

Yes
No

Do you have children?*

Yes
No

What are their ages?*

Is anyone in your household allergic to pets?*

Yes
No

What type of pet causes the allergy?*

Where will you keep your dog?*

Indoors Only
Outdoors
Indoors/Outdoors

When will the dog be outside?*

When will the dog be inside?*

Where will your dog sleep at night?*

Do you have a dog door?*

Yes
No

Will you install one?*

Yes
No

Which rooms are off limits to your dog?*

Is the dog allowed on the furniture?*

Yes
No

When you are not at home, where will your dog be?*

Is anyone home during the day?*

Yes
No

How many hours will the dog be alone on average per day?*

Does anyone come on your property (gardener, pool cleaner, housekeeper, etc.) while you’re not there?*

Yes
No

Where will your dog be during those times?*

When you go on vacation, who will care for your dog (select all that apply)?*

Housesitter
Friend
Vet/Boarding
Other

Do you have any current pets?*

Yes
No

List current pets

Age	Breed (estimation)	Weight (estimation)	Male/Female	Spayed/Neutered/Unaltered	Up-to-date on vaccines?	Kept indoors/outdoors/both

Other information about current pets?

Do you have any former pets?*

Yes
No

List former pets

Age	Breed (estimation)	Male/Female	Spayed/Neutered/Unaltered	Kept indoors/outdoors/both	Reason not in possession

Other information about former pets?

Have you ever lost a dog?*

Yes
No

How?*

What will you do if your dog gets out? Please elaborate.*

In the past, have you ever been forced to give up your dog?*

Yes
No

Reason(s) you could not keep the dog?

What did you do?*

What will you do if you can no longer keep your pet?*

What will you do if your dog gets sick?*

How much do you think vet care will cost?*

Are you prepared to spend the money, if needed?*

Yes
No

Do you have a veterinary spending limit?*

Yes
No

Explain the limit:*

Do you currently have a vet?*

Yes
No

Veterinarian Name*

Veterinarian Phone Number*

A pet requires a lot of attention. Are you prepared to spend a lot of time with your new pet (for the rest of it’s life)?*

Yes
No

What will you do if your dog/puppy chews on your favorite shoes or furniture?*

What if he/she has accidents on your carpet?*

How will you get your dog/puppy to do what you want it to do?*

Have you ever trained a dog/puppy in obedience class?*

Yes
No

Do you still use those same training methods?*

Yes
No

Do you think it is necessary for your dog to wear an ID tag?*

Yes
No

Do you think it is necessary to maintain updated contact information on your dog’s microchip?*

Yes
No

Under what circumstances will you give up your dog? (Check all that apply)*

Explain*

If dog were to do one of the above behavior issues (nipping, biting, barking, digging, etc.), will you be willing to consult a trainer (to try to rectify the situation) before giving the dog up?*

Yes
No

Explain:*

Are you prepared to make a commitment of 15 to 18 years to this pet?*

Yes
No

Please provide two personal references (no relatives)*

We will not contact your references without letting you know first.

Name	Phone Number	Years Acquainted

If you have pictures of yard and home, you can add them here (photos cannot exceed 50 MB.)

Drop files here or

Additional notes

If you have any additional notes, please enter them here.

User Consent*

I agree to the terms listed below.

Adult dogs may be returned within 10 days for a full refund. Puppies may be returned within 10 days for an all but $100 refund of the adoption fee. After 10 days there is no refund to the adopter. The adoption fee is a tax-deductible donation.

Consent*

I agree to the terms below.

If applied and approved for a puppy, he/she must have all core vaccines and be spayed/neutered no later than 7 months of age and will not be used for breeding, as is required in the Poochmatch adoption contract.

We reserve the right to refuse any adoption that we feel will not suit the dog’s/puppy’s requirements. Dogs/puppies are fun, loving, playful, and a lot of work. Please be sure that you can make a commitment to the care of the dog/puppy before you decide to adopt one.

Name

This field is for validation purposes and should be left unchanged.