Dog Adoption Form
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1
2Saginaw County Animal Care Center
DOG Adoption Consultation Form
Date_______________
This Animal Care Center is happy you have chosen us to look for a pet. We are
responsible for all animals at this facility and reserve the right to place the animal
in a home that will be both beneficial to the owner and the pet.
NAME:__________________________ ADDRESS:_____________________
CITY:___________________________ ZIP CODE:______________________
PHONE-HOME:___________________ WORK:________________________
Email:__________________________________________________________
Household Information
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1.
Own
Rent/Lease home/apartment/condo
Live with parents
If renting, Landlord’s name/number: ________________________________
2. Number of adults in household: _____
3. Number of children in household: _____ Ages of children: __________________
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4. Does anyone in your household have allergies?
Yes
No
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5. Is anyone in the household afraid of dogs?
Yes
No
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6. Do you have any pets currently(cats/dogs)?
No
Yes If yes, please list below:
Type of pet
Breed (if dog)
Spayed/Neutered
Indoor/Outdoor
7.
Last 5 years, # of pets owned_______ What Happened?__________________
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8. Who is the dog for?
Self
Family
Friend
Relative
Other ______
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9. What is the reason?
Personal/Family Companion
Watch/guard Dog
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Child’s Pet
Companion for Pet
Other______________________
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10. Is your yard fenced?
Yes
No
If Not, how will you confine the dog?
______________________________________________________________
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