Adoption Application

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Browse our pets on our webpage, looking for homes.

NOTE:  Not all of our pets are online.

Come see our adoptable pets:

11144 US-42

Plain City, OH 43064

Please list up to 3 dogs. If you are interested in just 1 dog, do not list others
I am interested in adopting: *

Applicant Information

You must be 21 or older to adopt
Date of Birth:*
Home Address:*

Contact Information

Home Phone:*
Mobile Phone:*
Preferred Method(s) of Contact:*

Work Information

Place of Employment:*
Work Address:*

House Information

Do you own or rent your home?:*

You must provide written proof that you are permitted to have pets.  

Please note:  If “own” is checked, we will do a property search to verify ownership.

Landlord's Name:*
Landlord's Phone Number:*

Other Household Members Information

Besides yourself, how many other people live in the household?:*

Provide the following information for other household members:

  1. Full Name
  2. Age
  3. Sex
  4. Allergies
  5. Occupation
Other household member (#1):
Other household member (#2):
Other household member (#3):
Other household member (#4):
Other household member (#5):
Other household member (#6):
Do you have any current household pets?:*


How many current pets do you have:*

Provide the following information for your current pets:

  1. Name
  2. Animal/Breed
  3. Age
  4. Sex
  5. Weight
  6. Length of time owned
  7. Date of last vet check/ vaccination
Current Pet (#1):
Current Pet (#2):
Current Pet (#3):
Current Pet (#4):
Current Pet (#5):
Current Pet (#6):

Veterinarian / Personal Reference Information

  • Please list all the vets that have treated your current or past animals.
  • If you do not have any animals list a personal reference that is a pet owner.
Is this your first dog?:*
Clinic/Personal Reference Name:*
Clinic/Personal Reference Address:*
Doctor’s Name: *
Doctor's Phone Number:*
Other Veterinarians Used:
Have you ever owned a pet?:*

Pet History

List the following information for any previous animals you or your family have owned in the last 15 years:

  1. Name
  2. Species/Breed
  3. Years Owned
  4. How did you acquire this animal?
  5. Why do you no longer have this animal?
  6. How long ago was this?
  7. If deceased, what was the cause of death?
Pet History Details:

General Questions

1. Do you have a fenced outdoor area?: *
If so, please describe. If not explain how you will confine the dog to your property:*
2. Where will the dog live, eat and sleep? (Please explain fully):*
3. How will you provide exercise/entertainment for the dog?:*
4. Please explain your method of training/discipline?:*
5. Are you willing to obtain training for your dog if they display unwanted behavior? (i.e. chewing, digging, barking, house training). If no, why?*
6. How many hours daily will the dog be left alone?:*
7. How will your dog be cared for while you are away? a) at work b) on vacation*
8. Under what circumstances would you no longer be able to care for this dog? (Check all that apply):*

For the next question, please think about your lifestyle - are you active, in and out a lot, are there lots of children/people around, etc. or are you more sedentary, quiet, with few visitors? What personality in a dog would best fit your family’s needs and lifestyle? Would your dog go with you everywhere or stay at home with you a lot? Do you have other pets that need consideration?

9. Please describe the “perfect dog” for you. What characteristics/traits are you looking for? (i.e long hair,short hair,specific color,specific sex,age):*


*** You must be 21 years of age.

*** You must be willing to make a 10-20 year commitment to your new dog.

*** We do not adopt our dogs as gifts.

*** All dogs will be indoor companions. You must have a secure fenced yard or be committed to multiple daily leash walks in all kinds of weather.

*** All current pets in the household MUST be spayed/neutered and current on all shots.

Veterinarian references are verified.

*** Our adoption contract legally binds you to provide the dog with proper veterinary care, including a yearly wellness exam, up-to-date required vaccinations and emergency care if necessary. You will also keep the dog on monthly heart worm prevention.

*** Our adoption process intentionally takes several steps and cannot be completed in one day. The process may take a few days from the time you submit an application to the time the dog will be in your home.

Note: We love all the dogs in our program and they will always have a home with us. Please contact us if it is no longer possible for you to care for your adopted dog. All adoptions fees are considered donations and are used to help us continue to save,vet and provide for our dogs.

IMPORTANT: Expect a 7-14 day adjustment period for your new dog. Our dogs have been through  some recent changes in their lives and need a chance to adjust to their new surroundings.  I have read the above requirements and understand them to the best of my knowledge. I have   completed the application truthfully and to the best of my knowledge. I certify that the information above   is true and understand that false information will result in nullification of this adoption.

Your email address provided earlier will provide as your "electronic signature"

Do you agree with everything on this form, and are ready to submit for review?*

Do the math (add or subtract). Show us that you're not a robot (please):