dart pet adoption form

You may fill this form out online and we will use it when you come in person.

DART reserves the right to refuse adoption of any animal to anyone for any reason.

First Name:Last Name:
Name of Desired Pet:
Street Adress:
State:Zip Code:
Home Phone:Cell/Other Phone:
Email Address:Best Time to Contact:
Place of Employment:
Work Phone:
How did you hear about OMLC:
Why do you want a rescue dog:
How far are you willing to travel to pickup your rescue dog?
Please list all members of your household:
Humans (Names & Ages):
Dogs (Name, gender, age, breed, altered?):
Cats (Name, gender, age, breed, altered?):
Other Pets (type, name, age):
Do all household members want to adopt a pet?
If there are no young children living in your home, will your rescue dog have regular contact with any under the age of 10?
If yes, descibe:
If there are no other animals currently living in your home, will your rescue dog have regular contact/socialization with others?
If yes, descibe:
Do you own or rent your home?
How long at current residence?
If you rent, has your landlord provied written permission for you to have a dog?
Landlord's name?Phone Number:
Do you have a fenced-in yard?
If yes, please describe:
If you don't have a fence, are you willing to install one?
Do you have dog tie-outs?
Do you have overhead runs?If yes, length?
Does anyone in your household have allergies or asthma?
If yes, who/kind?
Are you aware that dogs can shed all year long?
Who will care for, train and exercise your rescue dog?
How will you exercise your rescue dog?
If you do not currently have a dog, have you ever owned a dog in the past for which you were the primary caretaker?
If yes, what happened to the dog?
Have you ever sold, given away, surrendered or put down a pet?
If yes, please explain:
Veterinarian Name:Phone Number:
Where will the dog live?Where will the dog sleep?
Where will the dog eat?Will the dog be allowed on furniture?
Will your dog(s) be allowed fre run of the house?
How many hours per day will your dog(s) be home without humans on a regular basis?
Where will the dog(s) be when you are not home?
Are you familiar with the use of a dog crate to train and/or confine the dog during your absence or at night?
Are you planning to use a crate?
What will you do with your dog(s) if you need to be away from home overnight?
Are you aware that costs of maintaining a dog can average $500 or more a year (food, annual check ups & shots, heartworm & flea/tick prevention, grooming, etc.)?

Will the rescue dog...
be tied outside?If yes, for how long:
live outside?be walked daily?
allowed to run free outside of a fenced yard?
have annual vet check-ups?receive formal obedience training?

If you move, what will you do with your dog(s) and other pets?
May we visit your home prior to the application approval?
Would you allow for a follow-up home visit from a representative before and after this adoption?
Are you aware of and do you understand the state/local ordinances concerning dog licensing?
Leashing / leash laws?
Has any member of your household been cited for licensing or leash law violations?
How many people in your family smoke?
Would you call OMLC at the onset of any type of illness or health problem within 30 days following this adoption?
What would you do if one of your pets requires significant medical attention?
How much would/could you spend on a vet emergency?

Preferences of rescue dog you would like to adopt:
Activity/Energy Level:

Would you consider a special needs or handicapped dog that may require medication for a permanent (but controllable) condition?
Anything you would like to add?

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