Dog Adoption Application

Please complete this application. You must be at least 18 years old to adopt. This application is used as a tool to help find the best possible home for the animal and the best possible match for your home and lifestyle

The adoption application fee is $10. We will begin processing your application after payment is submitted.

First Name

Last Name

Primary Phone

Secondary Phone

Address

City

State

Zip Code

E-mail

Date of Birth

Drivers License Number

Drivers License issue date

Drivers License expiration date

Are you applying for a particular dog?

Yes

If yes, please enter the number you see on our web site for the dog

Do you

Own

Rent

Other

If other, explain

How long at current address?

If less than 6 months-previous address

Will you be moving soon?

Yes

Do you live in

House

Apartment

Mobile Home

Other

Landlord name and phone number (if you don't own)

Do other adults live in this house?

Yes

Have they approved of this adoption?

Yes

How many children live in this house?

List the Children's ages who live in this house

Where will this animal be kept during the day?

Where will this animal be kept while you are at work?

Where will this animal be kept in the evening?

Will this animal be

Indoors

Outdoors

In/Out

How will you confine your new pet on your property?

Why do you want to adopt a pet?

Do any members of your family have allergies to animals?

Who will be the primary caretaker of this pet?

Who are you adopting this pet for?

How much do you anticipate spending yearly on a pet you adopt?

If your adopted pet becomes destructive or is not housebroken, what would you do?

Under what circumstances would you not keep this pet?

Please list the pets that you currently own or reside at your home. Include type of animal, male/female, Age, Current of Vaccines, currently licensed and where did you get this pet?

Please list the types and breeds of pets you've owned in the last five years. Include age, how long you owned, and where the animal is now.

Do you have a veterinarian? If yes, please provide your veterinarians name and address.

Return Policy

If you are unable to keep this dog, you are required to return the dog to our shelter. You may return the dog within 90 days for a full refund.
If you return the dog after 90 days, you will be required to pay a $125.00 surrender fee.

1. All dogs adopted from Clackamas County Dog Services are implanted with a microchip. Registration of that microchip is a part of your adoption process.

2. If you move, what will you do with this animal?

3. Adoption from our shelter requires you to Spay/Neuter this animal, do you have any objections to this procedure

Yes

If you object, why?

Would you be willing to permit a visit by a representative of Clackamas County Dog Services:

Yes

5. Where did you hear about our adoption program?

IMPORTANT:

Adoption fees are non-refundable.

Please note: Completion of this application does not guarantee approval for the dog listed on your application. The application is one step in the adoption process.
Applications require a $10 non-refundable deposit, which will be applied to the adoption fee if you choose to adopt at our shelter within 1-year of the date of application. Adoption applications are valid for 1 year.

By clicking on "Continue", I certify that the information provided on the adoption application is true and accurate to the best of my knowledge and that falsification of information can be cause for denial of my application. I agree to sign and abide by the adoption agreement.

THANK YOU FOR YOUR INTEREST IN ADOPTING!

Return Policy