Pet Dog Adoption Released Dog Application "*" indicates required fields Name* First Last Birthdate* Month Day Year Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Home Phone*Cell Phone*The following questions will help us select the right dog for your home.Please choose the appropriate answer.Does everyone in your home want a dog?* Yes No Is anyone in your home allergic to dogs?* Yes No How do you plan to handle the allergy?Do you have toddlers/children living in your home or that visit often?* Yes No Please describe your home, yard and neighborhood.*Is your yard fenced?* Yes No Will you keep the dog on a leash when taken outside if not in a fenced-in area?* Yes No If no, please explain:*Please indicate N/A if appropriate.Have you ever owned a dog before?* Yes No Do you consider yourself an experienced dog owner?* Yes No 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?* Yes No CommentsAre you willing to use a crate for training purposes if we recommend it?* Yes No Do you have another dog at home?* Yes No If yes, what breed? Age? Sex? Spayed or neutered?*Please indicate N/A if appropriate.Do you often have visiting dogs or wish to visit dog parks or other places where he/she will interact with other dogs?* Yes No Do you have any other pets in the home?* Yes No If yes, what kind of pets?*Please indicate N/A if appropriate.What kind of dog are you looking for?Age*Sex* No preference Male Female Breed* No preference Labrador retriever Golden retriever (fewer available) Color*Color applies to Labradors only. No preference Black Only Yellow Only Activity Level*Please choose all that apply. Less active Average Very active No preference Desired Personality Traits*About your familyWhat are the ages of the people living in your home?*Are there any persons (children, elderly, etc.) with special needs in your home?* Yes No If yes, please explain.*Please indicate N/A if appropriate. Who will be the primary caretaker of your dog?*How would you describe your dog's primary caretaker?* Physically active and strong Average activity and strength Not very active or strong Other If other, please explain:How many hours will your dog be left alone during the day?*Where will your dog be left when alone?*Please describe what a typical day may look like for your dog.*Where will your dog be kept during the day? Night?*Have you owned dogs prior to these?* Yes No If yes, what happened to them?*Please indicate N/A if appropriate. 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?*We do not advocate the use of dog parks; dog’s only want a few good friends. They can cause social problems, be potentially injury causing, be dangerous, can be stressful, and germ passing. Is this policy something you can adhere to? How did you hear about BluePath?*Please list a name if you were referred.Please list your veterinarian.*If this is your first pet, please list whom you plan to use for your dogs health and wellness needs.Veterinarian Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Veterinarian Phone Number*Background Check Consent*Please note that all primary caregiver(s) and any other adult(s) with significant roles in the dog’s handling and care will be subject to a background check. I understandAnything else you'd like us to know?*Please feel free to add any additional information that you feel may be helpful in finding the perfect match.CAPTCHA
