Adoption Application

Home
About
Adoptable Animals
- Petfinder
- Application
Programs
How to Help
- Volunteer at Our Farm
- Other Ways To Help
Contact

ADOPTION APPLICATION

Five Freedoms Farm, Inc

Your Name Address:
City: State: Zip Code:
Cell Phone: Home Phone:
Email:
What dog are you interested in adopting?
What are you most hoping for in a new doggie companion?
Do you rent or own your current residence?
If you rent, does your landlord allow pets?
What is your landlord’s name and phone #?
If required, have you paid a pet deposit?
Is your pet going to be a gift? Yes No
Are you 21yrs or older? Yes No
Do you live with relatives or a roommate? Yes No
If yes, are they aware that you are planning on adopting a pet? Yes No
Does anyone in your house have known allergies? Yes No
Have you owned pets in the past? Yes No

If yes, what happened to them?

Do you have children living in the home? Yes
If yes, what are their ages?
Do you currently have other pets? Yes No
If yes, please specify how many, type and ages:
What is your favorite thing about your current pet(s)?
Are your pets currently up to date on shots? Yes No
Are your pets spayed/neutered? Yes No
What is your vet’s name and phone number?

Please check one:

I know and understand about heartworm disease and prevention I need information about heartworm disease and prevention

For which of the following reasons would you give up your pet?

(Check all that apply)

Moving
Divorce
Financial
Shedding
Medical problems
Not getting along with your kids
Not getting along with other pets
Aggressive
Allergies
Not under any circumstances

What is the longest stretch of time the pet will be left alone?
What percentage of the time will your pet be indoors?
What are you most looking forward to about adopting this dog?