Primary Contact:                                                                                                             Secondary Contact:
        
  
        
  

        
  
        
  









Contact Information:
         
                             ,   ,  
               
                         
     Area Code[999]   Phone #[999-9999]   Extention[9999]:
     Home:      Work:        Cell:    


Household Information:
              
                 
     Housing Situation (House, Apt., Trailer, etc):          ...........................  
      ............................................. ,          
     Where will the dog primarily be kept?        Is someone home during the day?  
     If no, approx. how many hours will the dog be alone?  
     Where is the dog going to stay during the day?     At Night?  
     Do you have a completely fenced-in yard (Yes/No)?  
     If yes, how high and/or additional comments?
    


Current and Past Pets:
     What animals are currently living with you?      (Name, Type, Age, Spayed or Neutered)
    

     Do/Did you use heartworm prevention medication on current or past pet(s)?        If so, what brand?  
     Do/Did you use flea and tick prevention medication on current or past pet(s)?      If so, what brand?  

     Please list any pets (dogs and cats) that you have had within the past 5 years not listed above.
     What happened to them? (If given away or euthanized, please explain)
    

     Rate your level of experience in dog ownership (Beginner, Intermediate, Advanced)     
     Are you willing to crate train the dog? .......................................................................................
     Do you have any experience with obedience training? .........................................................   
     Are you willing to hire a dog trainer or behavioral specialist if problems develop? ........   
     How do you plan do provide the proper level of exercise for the dog? ..............................
     How will you discipline the dog when needed? ....................................................................
     If Applicable, what brand of dog food do/did you use? .........................................................   


Veterinary Care:
    (Please understand that the information provided in this section is of vital importance to FOREVER HOME)
    A dog must be seen by a veterinarian at least once a year for a check up, it must receive immunizations as
   recommended, be tested for heartworm & lyme disease (commonly know as the 4DX test) and be on
   heartworm prevention as recommended by your Vet.


    Are you willing to commit to this level of care? ........................................
    Forever Home will contact your current Veterinarian(s) to affirm that you provide proper levels of care
     for current pets.
                          
                      



    Why do you want a dog?    

     If there is a particular dog you are interested in, please list name(s):         

     Please list the behavioral traits or strengths that are important in your new dog:
    
     List any traits you would like to avoid in a dog:
    
     Anything else we should know about what you are looking for in a dog?
    

     Please provide two unrelated references that we may contact:
                                 
                                 

         Please contact your Veterinarian to release your vet history to Forever Home representative
       after submission of this application.
       Thank You!



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