Adoption Form

First Name *

Last Name *

Email *

Address *

Suburb *

State *

Post Code *

Phone *

Which dog are you interested in? *

Why are you interested in this dog? *

Do you have any previous experience with this breed? *

Yes
No

Briefly explain you experience. *

Why do you want to adopt a Rescued With Love dog? *

What sort of owner are you? *

Do you have any other pets? *

Yes
No

List any current pets including sex, age and breed. *

Select all that apply to you existing pet. *

- Sociable, gets on with other dogs, happy to share with other pets
- Reserved but social, shy but basically ok with other dogs
- Unsure, can like some dogs but not others
- Unsocial, does not like other dogs
- Friendly with all humans, including children
- Likes people but not that interested
- Ok with some people but not others
- Does not like children
- Does not like any humans but you

Are all your pets desexed? *

Yes
No

Please describe the reason your pet is not desexed. *

Have you had any previous pets? *

Yes
No

List any previous pets including sex, age and breed. *

Have you ever surrendered a pet to a pound or shelter? *

Yes
No

Please describe the circumstances. *

Why are you considering adopting a new dog?

- For your children
- As a gift for someone
- For protection i.e. a guard dog
- As a companion for your existing pet
- As a companion for you
- Your last pet passed away and the time is right

Under what circumstances would you give up your pet? ie death in the family, barking, digging, cost, new baby etc. *

Describe where your new pet will sleep. *

Describe the diet you will provide for your dog. *

Do you have a doggie door that provides 24hr indoor/outdoor access? *

Yes
No

How often can you exercise your pet? *

Can you commit to providing training either at home or at a dog obedience class? *

Yes
No
Not Sure

Please tick what you are able to financially provide for your pet. *

- An annual vaccination
- Monthy flea treatment
- Monthly Heartworm treatment
- 3 monthly worm treatment
- Dental work
- Vet care in case of accidents
- Council Registration
- Schooling/training
- Accommodation during holidays
- Required grooming
- $400 adoption fee

What is your work situation? *

How would you describe your household? *

How many adults live in your house? *

1
2
3
4
5
6+

How many children live in your house? *

0
1
2
3
4
5
6+

Please list the ages of each child. *

What type of residence do you live in? *

Are you currently renting or in a property with a body corporate? *

Yes
No

Do you have a letter of proof of permission from the body corporate/real estate agent or landlord, or a contract, allowing another dog? *

Yes
No

Do you have secure fencing? *

Yes
No

Please describe your fencing. *

Do you have a pond, swimming pool, lake, river or dam on your property? *

Yes
No

Please describe the pond, swimming pool, lake, river or dam on your property. *

If you became ill is there someone who can care for your pets? *

Yes
No

If you go on holiday, what do you do with your pets? *

Do you object to a house check being carried out? *

Yes
No

Vet Name

Vet Address

Vet Phone

I agree to the Terms & Conditions. *

Adoption Form

Your Details

Pet Details

Pet Ownership Details

Your Lifestyle

Vet Details

Terms & Conditions