EmailMe Form - Dog Application

Are you interested in a specific animal? Please list their name here:

2. If not, what type of animal are you looking for? Please list desired age, weight range, breed, and gender – OR – describe the characteristics that would make an animal a bad fit for your home:

Name *

First Last

Email

Phone *

### - ### - ####

Spouse/Significant Other's Name

First Last

Spouse/Significant Other's Phone

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Do you rent? If so, please give the rules governing pets and the Landlord's name and number below. By providing this information, you are allowing Animal Aid of Tulsa to contact your Landlord. Please inform them of this call so they are aware.

Yes

No

Landlord's Name

First Last

Landlord's Phone

### - ### - ####

What type of home do you live in: single family, town home, apartment, farm, etc? If you rent, please give the rules governing pets: *

If in a house, do you have a fenced in yard? *

Yes

No

N/A

How many adults are there in your family?
(Please list their relationship to you)
How many are children in your family? (List ages) *

Please describe your household: *

Active

Noisy

Quiet

Average

Do you have time to provide adequate love and attention? *

Yes

No

Will this animal be primarily indoors or outdoors? *

Indoors

Outdoors

Both

Describe the home environment for the pet? Where will the pet be kept when you are gone? Where will the pet sleep? *

How much time will this pet spend alone each day? *

How much time are you willing to allow your pet to adjust to its new environment living with you? *

Do you plan to work with a trainer? *

Do you have other pets in the home? (Please specify how many, name, age, and breed) *

AAT requires all pets to be spayed/neutered, up to date on vaccines, and current on some form of flea and heartworm prevention? Are your pets currently up to date on all these things? *

Yes

No

If not, why?

Are you willing to get your pet(s) up to date in order to adopt with Animal Aid of Tulsa? *

Yes

No

Have you ever surrendered a pet, euthanized a pet, or lost a pet to an accident? If so, why? *

How do you discipline your pets, and why? *

VETERINARIAN

Do you have a regular veterinarian? *

Veterinarian's Name:

First Last

Clinic Name:

Clinic Address:

Clinic Phone:

### - ### - ####

By checking this box, I authorize Animal Aid of Tulsa to contact my vet and verify this information. I will also call my vet in advance to authorize the release of information to Animal Aid. *

Yes

Provide 3 Personal References and Phone Numbers: *

Please tell us how you heard about Animal Aid:

By checking this box, I am stating that all of the information I have given is true and complete. This dog will reside inside my home as a pet. I will provide the dog with quality cat food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian. I will contact Animal Aid of Tulsa if I can no longer care for this dog. I have indicated that this is a valid and legal substitution for my written signature on this legal document entitled 'Adoption Application'. *

Yes

Single Line Text

Checkbox

First option

Second option

Third option

Checkbox

First option

Second option

Third option

Checkbox

First option

Second option

Third option