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ABOUT LUCKY DOG RESCUE
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HAPPILY EVER AFTER
ADOPT
ADOPTABLE DOGS
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OUR PARTNERS
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MADDIES TREATABLE ASSISTANCE PROGRAM
CONTACT
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Adoption Application

If you’re interested in adopting a dog, please complete our Adoption Application below. When complete click the “SEND” button. We will contact you shortly.

Your First & Last Name (required)

Name of Dog

Phone

Your Email (required)

Subject

Your Address

Your City and State

Names & Ages of all Household Members

Have you ever owned a dog?
YesNo

Anyone in your household have pet allergies?
YesNo

How much time can you allow your dog to adjust to your new home?

Circumstances that could result in return of dog:
Job LossDivorceRelocationNew BabyIllnessBehavioralUnlikely

Household activity level:
LowModerateActiveVery Active

How often will you walk the dog?

How long will the dog be left alone on a typical day?

Who will take care of your dog when you are away on vacation/trips?

Will the dog be left with unsupervised children?
YesNo

Are you willing and able to pay your pet’s veterinary costs?
YesNo

Your Home

Type?
HouseApartmentCondoOther

Own?
YesNo

If rental, may we contact your landlord?
YesNo

Please provide landlord contact information

If rental, does your lease contain dog breed restrictions?
YesNo

If rental, does your lease contain pet size restrictions?
YesNo

Does residence have a yard?
YesNo

How high is the fence?

Do you agree to have your home and property checked?
YesNo

Other Pets In Your Household

Pet Type/Name #1

Spayed or Neutered?
YesNo

Indoor or Outdoor?
IndoorOutdoor

# of Years Owned

Age

Pet Type/Name #2

Spayed or Neutered?
YesNo

Indoor or Outdoor?
IndoorOutdoor

# of Years Owned

Age

Pet Type/Name #3

Spayed or Neutered?
YesNo

Indoor or Outdoor?
IndoorOutdoor

# of Years Owned

Age

Additional Information

Name/address of your veterinarian

May we contact as a reference?
YesNo

Veterinarian Phone Number

Will the dog live
InsideMostly InsideOutsideMostly OutsideOutside Only

Will the dog spend nights
InsideMostly InsideOutsideMostly OutsideOutside Only

Where will dog stay when alone?
InsideOutsideBoth

Where did you hear about Lucky Dog Rescue?

Any questions or comments, tell us more about yourself

I am at least 21 years old. All of the provided information is true and complete. I understand Lucky Dog Rescue has the right to refuse my application. I understand the adoption fee of $250 is requested at the time of adoption to help us with veterinary, foster care and other expenses. A home visit will be required prior to adoption.

I Agree

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