What is your household's general noise and activity level? --Select-- Low Moderate Active Very Active

Housing Type --Select-- House Condo Apartment Townhouse Dorm Mobile Home

Housing --Select-- Own Rent Live with Parents

Name and ages of all people in your household

If you are interested in a specific dog, please provide their name(s):

Are you 18 years of age or older?

Has anyone in your household ever been convicted of an animal related offense? Yes No

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If yes, please explain:

How did you hear about adopting through Dallas Pets Alive? Adoption Event Adoption Website (Petfinder, Adopt-A-Pet, etc.) Facebook Friend or Family Instagram Radio or TV Search Engine (Google, Bing, etc.) CW33 Segment Spotted Dog Architecture social media post Subaru customer newsletter Thryv Organics social media post WattDawg Other Adoption Center at Community Beer Co

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If you were referred though a friend or family member, what is their name?

Will you be leaving for an extended period of time or moving within the next 60 days? Yes No

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Do you have a fenced yard at your residence? Yes No

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Who will be the primary caregiver of this dog?

If something should happen to you or the primary caregiver, who would take responsibility for this dog?

Will others be handling or caring for this dog? Yes No

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Have you ever adopted from Dallas Pets Alive? Yes No

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Have you ever needed to surrender or rehome your pet before? Yes No

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If yes, please explain:

How many pets does your household currently have? --Select--   0   1   2   3   4   5   6   7   8   9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99

Include all animals in the home, even if they are not yours.

List the current pets in your household, including owner, name, type of animal/species, age, whether they are indoor or outdoor, and if they are spayed/neutered:

Why do you want to adopt a rescue pet?

Where will this dog stay the majority of the day? Indoors Outdoors Both

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Where will the dog be while you are not home?

Do you plan to use a crate with this dog?

How active do you want this dog to be? Very Active (needs a lot of daily exercise/running) Moderately Active (needs a walk and play time each day) Sedentary (couch potato)

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How important is it that this dog gets along with other pets? Extremely Important Somewhat Important Unimportant

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What activities do you plan to do with this dog on a daily basis?

Examples: walking/hiking, running, fetch, dog park, dog day care, obedience training, etc.

List three behaviors that, in your household, would result in a correction for the dog:

How do you plan to correct the dog if he/she does something wrong?

What will you do if this pet develops an unforeseen severe health or behavior problem?

Are you familiar with heartworm prevention? Yes No

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Do you plan to have cosmetic surgery performed on this animal, including but not limited to declawing, ear cropping, or tail docking? Yes No

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By entering your initials here, you consent for a Dallas Pets Alive representative to verify information with your veterinarian:

Please provide your landlord/apartment complex name and contact information:

Enter N/A if you do not rent your home

Would you object to a home visit by one of our representatives? Yes No

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By entering your name here, you confirm that you have read and understand the Factors to Consider Before Adoption outlined below.

If you have a promo code, enter it here:

*I have read and agree to the Terms and Conditions