Thank you for contacting our rescue! Our goal is to adopt loving dogs to responsible, loving, permanent homes. We would appreciate your help in filling out this form so we may find out more about you and your family! Today’s Date: Full Name: Address - House Number: City, State, Zip Code: Email Address : Alternate e-mail addresses or e-mail comments: Home Telephone Number and Best Times to Reach You: Work Telephone Number: Cell Phone Number: Occupation: Employer: How did you hear about PUP - Petfinder? 1-800-Save-A-Pet? Other? (Please Specify) In which dog/dogs are you interested? First choice: Second choice: If these choices are not available, what age do you prefer? Breed? Male or Female? I understand there will be an adoption fee that includes vaccinations, teeth cleaning (if needed) and altering (IF over 6 months of age). Please answer Yes or No. I understand that PUP does not refund adoption fees. Please answer Yes or No I agree to a pre-adoption home visit. Please answer Yes or No. Please understand that this dog MUST be an INDOOR pet and will not be left unattended outside. Your vet will be contacted as a reference to confirm ALL your pets’ current vaccination and spay/neuter status. Please list multiple vets, if necessary for reference. I have contacted my vet(s) and given them permission to release information to PUP. Please answer Yes or No. Veterinarian's Name: Veterinarian's Address (please include city): Veterinarian's Phone Number: If you have no vet, do you agree to provide PUP with this information within 2 weeks of adoption? Please answer Yes or No. If you do not have a current vet but have had one in the past, please list your former vet's contact information. They keep old records on file for several years and it will still be helpful in the approval process. How many adults reside in your home? What are their ages? How many children reside in your home? What are their ages? Do children visit your home? What are the ages of visiting children? What is the age of the primary person that will care for the dog you want to adopt? Does everyone in your household want this dog? Please answer Yes or No. Does anyone in your household have pet allergies? Please answer Yes or No. If yes, what type? Do you live in a house/apartment/condo? Do you own or rent your home? If renting, do you have permission from the landlord? Please answer Yes or No. Name and phone number of landlord: Do you have a fenced yard? Please answer Yes or No. If yes, what type of fence? Is the fence in good repair? Please answer Yes or No. How high is the fence? If no, how will you handle exercise and toilet duties? If an apartment/condo, how will you handle exercise and toilet duties? Do you have a pool? Please answer Yes or No. If so, is there a fence around it? Please describe. Do you work outside the home? Please answer Yes or No. Will the dog be home alone while you are at work? Please answer Yes or No. Will the dog be alone for 4 or more hours at a time? Please answer Yes or No. If yes, where will it be kept? When you go on vacation, where will the dog be kept? What would happen to the dog, should you decide to move? Do you own a dog now? Please answer Yes or No. Please describe: Name(s) Breed(s) Gender(s) Age(s) Altered? Comments Besides dogs, do you have any other pets? Please answer Yes or No. If yes, what are they (cats, ferrets, rabbits, etc.): Name(s) Pet(s) Gender(s) Age(s) Altered? Comments Have you owned any other pets in the last 10 years? Please answer Yes or No. Please describe: Name(s) Pet(s) Gender(s) Age(s) Altered? Date, if deceased Where is pet now? Why do you want a rescued pet and how are you prepared to meet their special requirements? Are you aware that a dog can live upwards of 14 years and are you committed to care for it that long? Please answer Yes or No. Do you realize that a dog can shed 365 days a year? Please answer Yes or No. Are you aware that some long coated dogs are higher maintenance, requiring grooming; and all require ear and nail care? Please answer Yes or No. Would you be willing to housebreak a dog if necessary? Please answer Yes or No. Are you familiar with dog health problems? Please answer Yes or No. Are you willing to administer daily medication, should a health condition require it? Please answer Yes or No. What is your philosophy regarding dogs which develop medical problems and how would you deal with them? Important Health and Temperament Notice: We make no explicit or implicit guarantees in reference to the health and/or temperament of the dog. The dog is adopted "as is" and the adopter assumes all responsibility for treatment of any and all existing conditions or any other conditions of physical or temperament changes that may occur. People United for Pets will provide the dog with the basic vaccines before adoption if the age and current health of the dog permits. While People United for Pets makes every effort to place only healthy animals, we cannot guarantee the health of any animal and shall not be held responsible for any medical expenses which may be incurred, hereby expressly excluding any implied or express warranties of merchantability or fitness for any particular purpose, including, without limitation, any warranties regarding health, temperament or whether the animal is housebroken. I am at least twenty-one (21) years old, ready to adopt and take possession of a dog now. Initials and date ==> I understand that this dog MUST be an INDOOR pet and will not be left unattended outside. Initials and date==> If this is a puppy adoption, I agree to Spay/Neuter the pup at 6 months of age or as soon as my vet recommends. Initials and date===> I understand if for ANY reason this dog DOES NOT work out, I will RETURN it to People United for Pets. Initials and date==> The adopter further agrees to accept all responsibility for any harm caused by the dog to humans, other animals or personal property following adoption, including, without limitation, any damages resulting from bites, scratches, or any other form of aggression, and any damages resulting from the dog's failure to become housebroken. Please answer Yes, I agree or No, I do not agree. Initials and date==> CONFIDENTIAL People United for Pets PO Box 1691 Issaquah, WA 98027