Adopt a Dog - Pet Allies in Arizona Showlow and the White Mountains

Pet Allies

Pet Allies
P.O. Box 415
Show Low, AZ 85902

(928) 532-1602

Pet Allies offers Spay/NeuterServices, Foster Care and Adoption Services to needy pets,

located in the White Mountains of Arizona

Dog Adoption Application

Click here for the PDF version of the Dog Adoption Contract

Enter the sum of the numbers that you see above.

Animal Information

Animal Name:
DOB/Age:
Color:
Sex:	Male Female
Breed:
Foster:

Adoptor Information

Name:
Spouse's Name:
Street Address: (no PO Boxes)
Mailing Address:
City:
State:
Zip:
Cell Phone:
Home Phone:
Work Phone:
Email Address:
Best time to call:
Major cross streets/landmarks:

Alternate Contact (outside of household) for emergency and/or reference.

Name:
Phone:

About Your Home

1.	Have you ever adopted an animal from PET ALLIES before? Yes No If yes, do you still have the animal? Yes No Have you ever requested assistance from PET ALLIES? Yes No What was the nature of the request? Spay/Neuter Adoption Relinquish a pet Pet behavior questions Pet food assistance Other If other, please elaborate
2.	How would you classify your home? Calm, Fairly Quiet Moderately Active Very Active
3.	What type of home do you live in? House Trailer Apartment Other
4.	How long have you lived at your present address? If less than one year, give previous address:
5.	Do you own your home or do you rent? Own Rent If you rent, do you have permission from your landlord to keep a pet? Yes No Is there a size or weight limit on pets? Yes No
6.	May we have permission to contact your landlord? Yes No Your landlord’s name and phone number:
7.	Age and sex of any children in the household:
8.	Are there any other residents at the house? Yes No Are all household members in complete agreement to adopting, care for, and training your pet?, Yes No
9.	What are the occupations of the adults in the household?
10.	Is anyone home during the day? Yes No Is anyone home at night? Yes No
11.	Do you have a doggie door? Yes No
12.	Is your yard fenced? Yes No Please describe your fencing (height, material). Does it completely enclose a yard for a dog? Yes No
13.	If you moved would you take your pet with you? Yes No
14.	Do you foresee any situation in the future that would cause you to give up your pet? Yes No If yes, what would you do with the pet?
15.	How many hours a day would your pet be left alone?
16.	Would you be able to tolerate a few accidents in the house while your pet adjusts to your home? Yes No
17.	Do any family members have allergies to pets? Yes No

Your Experience With Pets

1.	Have you had pets in the past? Yes No If yes, what happened to them?
2.	Do you currently have pets in your household? Yes No If yes, what kind? Have these pets been spayed/neutered? Yes No
3.	Are you looking for an indoor or outdoor pet? Indoor Outdoor Both
4.	If you do not currently have a pet, have you owned a pet before Yes No If yes, what kind?
5.	Have any of your pets been ill in the past year? Yes No
6.	Have you ever had to relinquish a pet? Yes No What were the circumstances?
7.	Have any of your pets ever had a litter? Yes No
8.	May we contact your preferred veterinarian? Yes No Veterinarian’s name and phone number:

Caring for your Pet

1.	Who will become the primary caretaker for your pet?
2.	Where will your pet sleep at night?
3.	Where will your pet be housed during the day when you are home?
4.	Where will your pet stay while you are gone during the day?
5.	How often do you travel? When you travel, where will the pet be boarded? (kennel, friend, trainer, groomer, vet)
6.	How will you transport the pet in a vehicle?
7.	How will you exercise the pet? (Daily walks, tennis ball play, jogging, swimming, hiking, running free)
8.	Emergencies can run anywhere from $250 to $1000. Are you able to pay for regular veterinary care as well as emergency veterinary care if it were to arise?

Training your Dog

1.	Will you agree to take the dog to obedience classes if recommended by PET ALLIES?
2.	Have you ever completed an obedience class with a previously owned dog or current dog? Yes No If Yes, what training techniques did you learn?

Adoption Terms: Please read the following information carefully. PET ALLIES believes the animal you are adopting is in good health (unless otherwise noted below). PET ALLIES provides a 10 day medical assistance program. Should any medical problem arise within 10 days of the date of adoption, contact PET ALLIES voice mail immediately at 532-1602. You will be referred to a veterinarian and PET ALLIES will pay for necessary treatment up to One Hundred Dollars ($100). If you are approved for adoption of this animal, you will be given the number of a volunteer to call in case of an emergency. If you take the animal to the veterinarian without prior written approval or otherwise fail to follow our instructions regarding treatment, the 10-day medical assistance program is void and you will not be reimbursed. The 10-day health guarantee does not cover injuries to the animal. Pet Allies also furnishes one month free health insurance through Petfinder.com. I agree not to dispose of or give away the animal without first notifying PET ALLIES. I, the adopter am responsible for the medical treatment, food and well-being of the animal. I agree to provide the animal with the necessary shots at the date advised by a veterinarian or by PET ALLIES medical records. I agree that the adopted animal will not be transported in the open bed of a pickup truck or similar conveyance unless confined in a pet carrier which is safely secured in said vehicle. I agree to have the adopted animal under your control when outside. I also agree that the adopted animal will not be tied or chained. I agree to a home visit by a volunteer to see how your new animal is adjusting, or prior to adoption if you live outside Pet Allies’ local area or you are adopting an at-risk breed. Many pets have behavioral problems such as chewing, fence jumping, separation anxiety, housebreaking, etc, especially in a rescue situation. The pet’s normal personality will show itself over a period of time from 2 weeks to a month. In order to adopt an animal from us, we require that you be willing to work with these problems with the help of a behaviorist. All the information I have provided on this application is, to the best of my knowledge, true and complete. I understand that falsifying answers on this application, or any other time during the adoption process, disqualifies me from adoption.
I hereby fully and completely release PET ALLIES and its officers, employees, agents and volunteers from any claim, cause of action or liability for any injury or damage which may be caused by the animal. I agree to fully and completely indemnify, defend and hold harmless PET ALLIES and its officers, employees, agents and volunteers from and against all claims, causes of action and liabilities, including but not limited to those asserted by third parties for any injury or damage caused by the animal.
I fully and completely release PET ALLIES and its officers, employees, agents and volunteers from any claim, cause of action or liability for any illness your other animals may develop, even if those illnesses are procured from the animal adopted from PET ALLIES.
There are no refunds of adoption fees.
I, the adopter, have read all of the conditions set forth in this adoption contract (including those on the reverse and following pages) and agree to abide by them.
I Agree	I Disagree

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MISSION: Provide non-lethal solutions to pet over-population.
SOLUTION: To furnish professional, affordable spay/neuter programs and to place pets in caring homes.

All Rights Reserved - 2007