DOG ADOPTION APPLICATION


Thank you for considering adopting a pet from our shelter! We will be happy to conduct an animal interaction if/when your application has been approved. Remember, you are potentially making a 10-year (plus) commitment. All dogs have been vaccinated for Canine distemper, bordatella and parvovirus. Your veterinarian may recommend additional vaccinations at the adopter’s expense. Puppies often require a series of vaccinations. Dogs over three months of age have been vaccinated for rabies. If your puppy is not already vaccinated for Rabies, you will be provided with a date/time to return for his/her vaccination. All dogs have a microchip as a permanent form of identification, have been spayed or neutered, and tested for Heartworm (if 6 months or older). Adoption fees are non-refundable. Your adopted pet must be taken to a veterinarian within 7-10 days of adoption for an exam and any necessary vaccinations/medications. You will be provided with a medical/vaccination record at the time of adoption that should be shared with your veterinarian.

Applicant Information

Date
Name*
Address*
How did you hear about us?

PLEASE LIST ANY PETS THAT ARE CURRENTLY IN YOUR HOME:

Animal 1:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 2:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 3:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 4:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

Animal 5:

SPAYED OR NEUTERED?
CURRENT ON VACCINES?

PLEASE LIST THE PETS YOU HAVE OWNED IN THE PAST FIVE YEARS:

Animal 1:

Animal 2:

Animal 3:

Animal 4:

Animal 5:

How many people are currently living in your home? *
Do you live in a single-family home, townhouse, condo, or apartment? *
Do you rent or own?*
If you own your home but the property tax bill appears in someone else's name, please list that here.

As you live in a Townhome or Condo, Animal Services will need a copy of your association by-laws.  If they are not available, we will request your association phone number to verify pets are allowed and check if there are restrictions.  

Personal Background Information

Do you have a fence?*
Describe the activity level in your household*
Have you ever given a pet away or relinquished a pet to a shelter? *

Matching the Right Pet

Why are you looking to adopt from our shelter? (Check all that apply)*
What traits are you looking for in a dog? (Check all that apply)*
Why do you want to adopt this dog? (Check all that apply)*
Where will you keep your animal when you are at home? *

Training

Please answer these questions to the best of your ability. Any questions you have can be discussed with an adoption counselor. 

Will you be taking your dog to training classes? *
Developing a new routine and bond with your dog may take several months,are you comfortable with this?*

Caring for Your Dog

Do you already have a Veterinarian? *
Owning a dog mean paying for food, toys, treats, vet care, immunizations, and more. A dog can live for 10-20+ years. Are you willing to budget for these expenses for the dog's entire life? *
Would you return a dog for any of the following reasons? (Check all that apply)*
Are there any topics you would like to talk about with an adoption counselor? (Check all that apply)*

By signing below, I certify that I am 18 years of age or older, the information that I have provided is true and that I recognize that any misrepresentation of facts may result in my losing the privilege of adopting a pet. I authorize DuPage County Animal Services to investigate all statements made in this application. I also understand that adoption may be refused at the discretion of the DuPage County Animal Services staff.

Use your mouse or finger to draw your signature above
Date/Time*
: