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. *

If we have listed any medical issues or behavioral problems with the dog you are applying for, how would you manage these? Please include and relevant 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