Atlanta Pet Rescue Adoption Application

Please fill in the following information and click on the submit button at the bottom of the page if you are interested in adopting a dog from Atlanta Pet Rescue and Adoptions. Be sure to print a copy and bring it with you to our adoption.  

Atlanta Pet Rescue and Adoptions does NOT adopt outside of Georgia.  

Also note that it may take up to 2 days before you get a response from Atlanta Pet Rescue and Adoptions regarding this application, so please be patient. Our  responses are initially via e-mail, so be sure your e-mail address is accurate below

Atlanta Pet Rescue reserves the right to refuse any applicant.

  Applicant:             Co-applicant (Spouse/Significant Other):

First Name:      
Last Name:      
Age:      
Occupation:      
How Long at this Job:      

Street address:
City:
State:
ZIP:
Home Phone:
Work Phone:
E-mail (required field):

What is the name  dog/breed you are interested in?
List any general questions you would like to ask about this particular dog:

Are you willing to allow a representative from Atlanta Pet Rescue to visit your home by appointment? Yes
No

Please check any of the following reasons for adopting this dog: family pet
child's pet
watchdog
companion
hunting dog
guard dog for business
companion for other pet
gift
other - please specify:

Please indicate where you live: apartment
house
condo/townhouse
trailer/mobile home

Do you... rent home
own home

If you rent, do you have the landlord's permission to own a dog? Yes
No
What is the apartment complex name?
What is the landlord's phone number?

How many times have you moved in the past 5 years?   times
If you move, will your pet go with you? Yes
No
Would you consider moving somewhere that doesn't allow your pets? Yes
No

Do you foresee any major changes in your life in the next 15 years (average lifespan of a dog) such as marriage, childbirth, health problems due to age, going away to college? Yes
No
If yes, please explain:
Do you or anyone in your household currently have any serious health problems? Yes
No
If so, please describe:
Can you provide a permanent home for this dog for 10-15 years? Yes
No

Do you have a fully fenced yard with no fence gaps? Yes
No
If yes, how high and what kind?

Number of adults in household?
Relationship(s): spouse
roommate(s)
life partner
other - please specify:
Does anyone in the household smoke? Yes
No
Will this dog be a surprise for any family members? Yes
No
If yes, who?
Do any family members have allergies? Yes
No
Do any children live in the house? Yes
No
If so, what are their gender/ages?

Number, type and age of pets currently in household?

Do any of your current or did any of your past pets live primarily outdoors? Yes
No
If yes, please describe pet:
Were all previous pets spayed/neutered? Yes
No
Are all current pets spayed/neutered? Yes
No

Do you know what heartworm disease is and how to prevent it? Yes
No
Is your current dog or was your previous dog on heartworm prevention medication? Yes
No
If yes, how often did you give the heartworm medication?
What brand did you use?
What is your veterinarian's name and phone number?
What do you expect annual pet care (vet care, medication, heartworm preventative, etc.) to cost yearly?

How many dogs have you owned in the past?
If any, please describe what happened to each of them (put to sleep, run over, died of old age, sold, given away, ran away, etc.)

Who will be responsible for the daily care and training of your new dog?

How do you plan to prevent fleas and ticks?
Are you aware of Frontline or Advantage? Yes
No

How many hours will the dog be home alone on a typical day?

Where does your current dog stay when home alone during the day? outside in fenced area
outside in dog pen
outside on chain or tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate
other, please describe:
Where will your new dog stay when home alone during the day? outside in fenced area
outside in dog pen
outside on chain or tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate
other, please describe:

Where do current pets sleep at night? dog house in fenced area
dog house in dog pen
dog house near tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate
in my bed
other, please describe:
Where will the new dog sleep at night? dog house in fenced area
dog house in dog pen
dog house near tie-out
inside in basement
in the garage
inside free run ofhouse
inside in one room of house
inside in crate
in my bed
other, please describe:

What percentage of time will the dog spend inside the house? %
Will your new pet be allowed on the furniture? Yes
No

Have you ever had a serious behavior problem with a previous dog? Yes
No
If so, please describe:

Do you have a doggie door? Yes
No
If not, and if it would work better, would you consider installing a doggie door? Yes
No

Have you always kept an ID tag (other than a rabies tag) bearing your phone number on your pets? Yes
No
Are you willing to keep a collar and ID tag on all of your pets including a new dog at all times? Yes
No

Under what circumstances do you think it is OK to leave a dog outside alone and unsupervised in an unfenced area? in a quiet subdivision
on a lot of acreage
in a rural area
when I know they are trained to come back
none

What circumstances, in your mind, justify giving a dog up? moving
new baby
not getting along with other pets
divorce
getting out of fence
behavioral problems
children lost interest
if it gets too big
too time consuming
shedding
allergies
housebreaking problems
medical problems
aggressive behavior
other - please explain:
Have you ever given a dog up or had a dog for a brief period of time and it didn't work out? Yes
No
If so, please explain the circumstances and what happened to it:

Have you ever looked at or applied for a pet with another rescue group? Yes
No
If so, how long ago? Did you adopt? Please explain:

If you are unable to keep your dog for any reason at any time will you return the dog to us? Yes
No

If you date or marry someone who does not like or want your pets, what would you do?

If your pet later develops a medical problem that becomes expensive, what would you do? Find another home for him
Pay whatever it takes
Have him put to sleep
Give him to a rescue group or shelter
other - please explain:

If your pet develops a frequent urination problem at the age of 12 and can't hold it when left alone, what would you do? Have him put to sleep since he is older
Babygate him in where flooring is not carpeted
Give him to a rescue group or shelter
Put in a doggie door
other - please explain:

If you are considering a long-haired breed, how often would the dog be groomed?
Would he get haircuts? Yes
No
Would you do it yourself? Yes
No
Have a groomer do it? Yes
No

What type of food will you feed? something from the grocery store
premium food from a pet supply store
Brand name:

Has a dog or puppy died on your premises in the last 6 months of distemper, parvo or unknown causes? Yes
No

Please list the names, addresses and phone numbers of 2 personal references:

How did you hear about Atlanta Pet Rescue? website
newspaper
word of mouth
radio
at an adoption day
other - please specify:

Typing your name below will serve as legal signature. By signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for denying the adoption of rescue dog and possible removal of dog adopted. Applicant must be 21 years of age or older. Atlanta Pet Rescue reserves the right to refuse any applicant.