Adopt – Good Omen Dog Rescue

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Adopt

Good Omen Dog Rescue uses this form to learn more about you and your household so we can help match you with the right dog. The information you provide guides us in finding the best fit for your family. Adopting a dog is a significant decision and a lifelong commitment, your input helps us ensure a successful placement.

"*" indicates required fields

URL

This field is for validation purposes and should be left unchanged.

What dog(s) are you interested in?*

About You

Please be as detailed as possible – the more detail, the better success we’ll be have in finding you the perfect fit!

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What is your employment situation? Work full time, retired, etc.*

Will you have any major life changes over the next two years? If so, how do you plan for your pet to be part of this?*

About Your Home

Please list all current pets (including dogs, cats, birds, small animals, livestock, etc):*

Species & Breed

Gender

Age

Fixed?

Temperament

(Use the (+) symbol to add more rows for more pets – enter n/a if not applicable)

Can you provide vaccines/spay/neuter certificate upon request for any current pets??*

Yes

No

n/a

Please list all pets from the last 10yrs, both those who have passed as well as who are no longer residing with you?

Species & Breed

Gender

Fixed?

Special medical needs?

Passed away or rehomed?

(Use the (+) symbol to add more rows for more pets)

For animals no longer in your home as a result of rehoming, please explain why the pet needed to be rehomed – this is not an automatic disqualification as we understand all circumstances are different.

Please list all people in your household INCLUDING CHILDREN as well as your relationship to them, and their commitment to the new pet – 0 indicates they do not want a dog, 1 indicates they are OK with a dog but don't want to be involved in care, and 5 indicates excited and motivated to provide the best care for the dog.*

Name

Relationship (or self)

Age

Commitment

(Use the (+) symbol to add more rows for more pets)

If you have a roommate, how will they be involved in your dog's care?*

Does anyone have an allergy to animals?*

Yes

No

If so what kind? (n/a if not applicable)*

How many hours will your dog be alone daily?*

Where will your dog stay when you aren't home?*

Where will your new dog spend time?*

Indoor

Outdoor

Indoor/Outdoor

Do you have a doggie door?*

Yes

No

Do you rent or own your home?*

Rent

Own

Landlord Name & Phone – enter n/a if yourself.*

( If rent, we will need a letter from your landlord.)

Is your yard fenced?*

Yes

No

Material and Height of Fence*

Do you have a pool?*

Yes

No

If yes, is it fenced?

Yes

No

About the Dog

Describe the type of dog you are looking for in as much detail as possible?*

How do you plan to exercise, mentally stimulate and socialize your dog?*

Age Preference*

Young Puppy

Older Puppy

Young Adult

Older Adult

Senior

Activity Level*

High

Medium

Low

No Preference

Characteristics (select all that apply)*

Companion

Protective

Obediant

Performer

Service

Special Needs

Veterinary Reference (it's ok if this is a past vet)*

Veterinarian Reference Address*

Street Address City State / Province / Region ZIP / Postal Code

Veterinarian Phone*

Veterinarian Email*

Unexpected Circumstances

For which of these reasons would you consider giving up a pet?

Please read thoroughly and check all that apply.

Moving

Divorce

New job / less time home

Birth of a child

Destruction of property

Financial hardship

Fights between animals in home

Resource guarding from other pets

Resource guarding from humans

Aggression towards a child

Aggression towards an adult

Extreme medical cost for the pet

Extreme medical circumstance for myself

Death

Other

If other, please specify

If you could no longer keep a pet, what would you do?*

Background

Be as detailed as possible.

Have you ever had a dog with behavioral issues? If so, please describe and tell us what you did about them.*

Have you ever lived with a dog from a rescue or shelter? If so please tell us about it.*

Have you ever purchased a dog from a breeder? If so, please describe your interest in now rescuing?*

Do you understand how the dog rescue process works?*

Are you willing to take responsibility for this pet for the next 10–15 years?*

Yes

No

What amount of medical care would you consider reasonable/necessary for your adopted dog?*

Routine Care (amount in dollars yearly for non-emergency care)

Emergency life-saving medical

What do you consider to be needed for a dog's annual medical care?*

Have you ever had a dog with a medical emergency or illness? If so, please describe how you cared for your pet.*

Acknowledgement

I confirm that the information I have provided is accurate and complete to the best of my knowledge.
I understand that providing false or misleading information may result in Good Omen Dog Rescue reclaiming the adopted dog from my care.

Home Visits

I understand that a representative from Good Omen Dog Rescue may conduct an initial home visit to confirm the accuracy of the information provided. An adoption contract must be completed and signed before the dog is officially considered yours. Your foster or representative will provide this form to finalize and verify the adoption.

Signature

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