Application Dogs

Application: Puppies & Adult Dogs
If you are completing an adoption application, please click on this link to read & also submit Adoption Agreement.

To download and print an application in pdf format, click here.

Application for Puppies and Adult Dogs

Please fill out this form completely and submit. An adoption counselor will contact you once it has been received and reviewed. Thanks so much!
Please understand that adopting a pet is a commitment for the animal's entire lifetime. Average lifespan for a dog is 10 to 16 years and a cat 12 to 18 years Please understand that you must be prepared to spend from $250 to $400 per year in veterinary fees for routine inoculations and preventative medicines. Costs can be higher in cases of illness or injury. Dogs require time and attention. Adopting a pet is a serious commitment that cannot be taken lightly.

Dog(s) of interest:
Name:
Email:
Phone #1:
Phone #2:
Address:
City, State, Zip:
Own or rent home:
House, apartment, condo, other?:
Landlord name:
Landlord number:
Fencing? Full, partial, underground, none, etc:
Fence type & height:
List all persons in household (ages for children):
List & Describe each pet you currently own:
Are all current pets spayed or neutered:
Are all current dogs on heartworm preventative at this time:
Are all current pets up to date on vaccinations:
Have you ever had a cat or dog before? If yes, for how long::
What happened to him / her:
Are you financially able to secure medical care for a sick or injured animal.::
Veterinarian number:
Veterinarian name:
Why are you interested in a pet now
Where will pet stay while you are gone:
Where will pet stay while you are at home:
How will a dog fit into your schedule:
Anything else you would like to share::
I hereby state that the information on this application is true and correct to the best of my knowledge. I am at least 18 years of. (provide name / signature):
Date:

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IMPACT for Animals PO Box 190184 St. Louis, MO 63119 (314)-995-9260 email: impactforanimals@aol.com

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