Dog Adoption Application

Please download and complete the above PDF application or fill out all the fields below. Once we have received your application we will review it and contact you. Please allow for 24-48 hours after your application has been submitted. All information is strictly confidential.

Adopter Information

First and Last Name *
Street Address
City
State
Zip Code
Phone Number *
Alt Phone ​​​​​​​
Email
Alt Email

Animal to be Adopted Information

Animal's Name
Gender
Species
Breed
Estimated Age
Color / Markings
Where did you first see this pet?

Application Questions

Are you able to provide the long term care a dog requires?
Are all the adults in the family aware of the adoption and committed to this pet's care?
Does your current house/apartment allow a dog of this breed and size?
If you will be moving, are you committed to finding a place to live which allows you to keep this pet?
Do you have children under the age of 18 living in your household?
If yes, please provide the ages:
Do you plan for this dog to be indoors, outdoors, or indoors/outdoors?
How do you plan to exercise this dog? (Check all that apply)
Other
If you have ever had to give up the ownership of a pet, please list the circumstances and what you did with the pet? (ex. find a new home, turn in to a shelter, turn in to a rescue group, etc.)

Current/Past Pet Information

Do you currently have pets in the household?
If yes, please list their names, age, and species:
If no, have you ever owned pets before?
If you answered yes to the question above, please list their names, age, and species of the pets you previously owned in the last five years:
Please fill in the following information if you currently have a dog in the household. If you do not currently have a dog, please fill in the information regarding the last dog you owned. If you have never owned a dog please skip to the next section.
Have your current dogs been to the vet within the past year?
Are your dogs up to date on Rabies vaccine?
Are your dogs up to date on DHPP vaccines?
Are your dogs spayed/neutered?
Do your dogs take monthly heartworm prevention?
Do your dogs take monthly heartworm prevention?
Do your dogs stay indoors, outdoors, or indoors/outdoors?
Please fill in the following information if you currently have a veterinarian. If you do not currently have one please skip to the next section.
Have all your other pets (including cats, horses, etc.) been to the vet within the past year?
Are all of your current pets up to date on vaccines?

Veterinarian Information

Please fill in the following information if you currently have a veterinarian. If you do not currently have one, please fill in the information regarding the last veterinarian you used. If you have never owned a pet before please skip to the next section.
Name of Veterinarian
Clinic Name
Clinic's Phone Number
Please have your current veterinarian fax us your current pet's or most recent pet's medical records to (864) 972-9963. This will help ensure a quick application process.
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Adoption Agreement

I agree that this animal is being adopted for myself/my family, not as a gift for someone else and that I am at least 18 years old. I agree to provide for the needs of this pet through his or her lifetime including food, water, shelter, and veterinary care. If at any time I am unable to provide for this animal, I agree to either return him/her to Crossroads Animal Hospital/Crossroads Animal Rescue (CAH/CARE); surrender him/her to a rescue group (not a shelter or rescue who euthanizes healthy animals); or find another home who will provide for his/her needs. If this pet is returned to CAH/CARE, there will be no refund of the adoption fee. I understand CAH/CARE makes no guarantee about this animal’s health status or temperament. If this pet is not already spayed/neutered, I agree to have this surgery done by the time the pet is six months old. This requirement can be waived only with a written statement from the pet’s veterinarian stating that spay/neuter surgery is medically contraindicated. If you fail to have this surgery done by six months old (unless advised differently by your vet), we reserve the right to take back ownership of the pet. I understand that future medical care of this pet is my financial responsibility, including illness or injury that occurs shortly after adoption or any injury/illness known to be present at the time of adoption. This pet appears healthy at this time (or as indicated above under “Known Medical Problems”), but CAH/CARE makes no guarantee to future health.
By submitting this form you understand and agree to the terms listed above. You also agree that the information presented is true to the best of your knowledge. Again by completing this form, you are not obligated to adopted. The application is part of the approval process.
Confirmation *
Please use this comment section to provide any additional information you deem necessary to your application: