Hallie Hill Animal Sanctuary Dog Adoption Application Form (Page 2 of 2) in pdf

Other pets currently owed:

Name: ____________________ Breed: _______________ Sex: ____ Age: ____ Altered? Y or N

Are all current pets up to date on their vaccines? Yes

Unsure

List previously owned pets in the last 10 years and why you no longer have them.

Name: ______________________Breed: __________________ Reason: ____________________________

Name of current (or previous) veterinarian: _________________________________________

Phone: (______)____________________________________

How do you correct unwanted behaviors in a dog? Please give an example. ____________________________

__________________________________________________________________________________________

Are you willing to allow a rescue member to visit your home by appointment before and/or after adoption?

Y N

Please add any other information you wish us to consider for possible placement of a dog with you: ________

_________________________________________________________________________________________

I declare that the above is true to the best of my knowledge and ability. I authorize the veterinarian listed

above to release medical information of my current or previous pets.

_________________________________________________

_______________________

Signature

Date

Hallie Hill Animal Sanctuary Dog Adoption Application Form Page 2