General Information How many times have you applied for adoption in the past year?
-- Select One --
0
1
2
3
4
5
6
More than 6
What was the outcome of the application & why?
(Required if answer above is 1 or higher)
Why are you interested in adopting a pet?
What characteristics are most important to you in a pet?
Do any family members have allergies to hair, dust or dander?
Are ALL family members in agreement about the adoption of a pet? yes
no
(Select One)
Where will this pet primarily be kept? indoors or outdoors?
(Select One)
When outdoors, will the pet be
tied/chained
free to roam
(fenced area)
free to roam (non-fenced area)?
(Select One)
Where will this pet be kept during the day?
How many hours at a time will this pet be left alone?
Who will care for this pet when you’re out of town?
Where will your pet sleep at night?
Do you own a pickup truck or jeep? yes
no
(Select One)
If yes, where, in this vehicle, will your pet ride?
What type of area is your home located in? Suburban Urban Rural
(Select One)
What type of residence do you live in? House
Apt./Condo./Townhouse
Mobile Home Farm
(Select One)
Do you own or rent your home/apartment?
own
rent (Select One)
If you rent, are you allowed pets?
yes
no (Select One) (Required if renting home or
apartment)
Is there a pet limit and weight limit?
yes no (Select One)
(Required if renting home or apartment)
If so, what is it?
(Required if renting home or apartment)
Property Name:
(Required if renting home or apartment)
Pet Deposit Fee Amount
(Required if renting home or apartment)
Property Manager’s Name
(Required if renting home or apartment)
Property Manager's Phone Nbr
(Required if renting home or apartment)
If you live in a house, do you have a secure, fenced in yard? yes
no (Select One)
What type of fence do you
have?
How tall is your fence?
(Dog Adopters) How do you plan to exercise your dog?
What is your family’s activity level? Athletic
Moderate
Medium
Low
(Select One)
Are you prepared for the financial responsibility of owning a pet? yes
no (Select One)
How many pets (dogs & cats) are currently in your household?
--- Select One ---
0
1
2
3
4
More than 4
List all current pets (dogs & cats only) in your household :
Other than those listed above, please list the pets (dogs
& cats) you’ve owned in the past 10 years.
(Please include Type, Breed, Name, Sex, Spayed/Neutered, Kept Where, Age, & What
Happened to Them)
Have you ever given up an animal for adoption or gotten rid of an animal? yes
no (Select One)
If yes, please state the reason and what you did with the animal:
List your current veterinarian:
Phone #:
Are your pets up to date on all their vaccinations? yes
no (Select One)
Are your pets on heartworm preventative? yes
no (Select One)
If so, what brand do you use?
Will you allow Tassie’s Hope to contact your veterinarian? yes
no (Select One)