Released Dog Application

Name *
Birthdate *
Home Address *
Home Address
Home Phone *
Home Phone
Cell Phone *
Cell Phone
The following questions will help us select the right dog for your home. 
Please choose appropriate answer.
Does everyone in your home want a dog? *
Is anyone in your home allergic to dogs? *
Do you have toddlers/children living in your home or that visit often? *
Will you keep the dog on a leash when taken outside if not in a fenced-in area? *
If no, please explain:
Have you ever owned a dog before? *
Do you consider yourself an experienced dog owner? *
Would you consider adopting a dog (at no charge or a reduced fee) with a medical problem that may require medication, restricted exercise or a special diet? *
Are you willing to use a crate for training purposes if we recommend it? *
Do you have any other pets in the home? *
Do you have another dog at home? *
If yes, what breed? Age? Sex? Spayed or neutered?
If you do not have another dog, do you often have visiting dogs or wish to visit dog parks or other places where he/she will interact with other dogs? *
What kind of dog are you looking for?
Sex *
Breed *
Color *
Color applies to Labradors only.*
Activity Level *
Please choose all that apply.
About your family
If yes, please explain.
How would you describe your dog's primary caretaker? *
What role do you want your dog to fulfill in your home? *
Choose all that apply.
If other, please explain:
If yes, how long?
Please list a name if you were referred.
If this is your first pet, please list whom you plan to use for your dogs health and wellness needs.
Veterinarian Address *
Veterinarian Address
Veterinarian Phone Number *
Veterinarian Phone Number
Please feel free to add any additional information that you feel may be helpful in finding the perfect match.