Dog Adoption Application

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Vet Information
Current Vet Name
Vet Phone Number
Vet Address
Street Address Address Line 2 City State ZIP Code
PLEASE CONTACT YOUR VET AND GIVE YOUR PERMISSION TO SPEAK WITH US ABOUT YOUR PETS. IF THEY DO NOT HAVE YOUR PERMISSION, IT MAY DELAY THIS PROCESS.
Previous Vet Name (If you have been there within the last 5 years.
Prior Vet Phone
Other Pets Information
Do you own other dogs?*
- Yes
- No
Provide name, breed, age, gender and if they are spayed/neutered.
Do you own cats?
- Yes
- No
How Many Cats?
Are they
- Indoor
- Outdoor
- Both
Please list any other animals in home (hamsters, ferrets, rabbits, etc.):
Please list any previous pets, noting name, species, breed and length of ownership
Have you ever re-homed a pet?
- Yes
- No
please explain the circumstances.

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References
Please provide two references – No family and no one living with you. Include name, phone number, and relationship.
Reference 1 Name:
Reference 1 phone:
Reference 1 relationship:
Reference 2 phone:
Reference 2 relationship:
Reference 2 Name:
Consent*
I agree to the Acknowledgement and Release Statement
Acknowledgement and Release Statement

I hereby release to FOWA Rescue access to all veterinary and town license records of any or all of the animals I own or have owned. I certify that all the information in this application is true and I understand that false information may void the application. All adoptions are finalized at the discretion of the review board. FOWA Rescue reserves the right to refuse any adoption and will not reveal the specific reason for adoption denial. FOWA Rescue reserves the right to contact any individuals listed on this form.
Electronic Signature (Type your name)*
Date*
MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

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Vet Information