Mutt Madd-ness, Inc. | 404.406.6322

Welcome to the Mutt Madd-ness Adoption Program. The following information is requested so that we can assist you in the selection of a new dog. This form and a consultation with a Mutt Madd-ness representative are designed to help you find the dog most compatible with your lifestyle. In order to be considered as an adopter you must:

Be 21 years of age or older.
Have identification showing your present address.
Have the knowledge and consent of your landlord.
Be able and willing to spend the time and money necessary to provide training, medical treatment
and proper care for a pet.

Completion of this application does not guarantee adoption of a Mutt Madd-ness dog.

The adoption process
Mutt Maddness has an adoption process that includes this comprehensive application and a home visit.

A Mutt Madd-ness dog is a Mutt Madd-ness Dog for life. These dogs have already been to shelters or rescued from abusive or neglectful situations and we do not want them to go back to that. You really are saving a life and if you stick with it, the reward will be far greater than any house training accident!

We ask that you take the time to fill out the form in its entirety. Thank you!

Adoption Fees

Downloadable version

Name
Address
City, State and Zip	,
Phone	Cell: Home:
Email
Age
Driver's License (State & Number)
Dog you are interested in.
Is this your first dog?	Yes No
How many cats and/or dogs have you owned in the past five years? Please Note: Breed / Age / Spayed-Neutered / How Long Owned
Are they current on vaccinations?	Yes No
What happened to the ones you no longer have?
Have you ever turned your dog in to a shelter? If yes, please explain.	Yes No
Have you had a pet euthanized? If yes, please explain.	Yes No
If you have other pets will they (or it) adjust to a new pet entering the household?	Yes No
Was your last dog obedience trained?	Yes No
Why do you want this dog?
How many adults are there in your family?
How many children? Children’s ages.
Does any member of your household have an allergy to dogs?	Yes No
Is someone home during the day?	Yes No
How many hours each day will the dog be without human companionship? Explain.
Which do you live in? If other, explain:
Do you own your home? If you rent, may we contact the owner to obtain permission for this animal to live in your home? Owner's name and phone number:	Yes No Yes No
Do you have a completely fenced yard? What kind of fence? Height ?	Yes No
Would you be able and willing to exercise the dog on a regular basis? Method:	Yes No
Are there times when the dog will be tied up?	Yes No
Will the dog spend any time in the garage?	Yes No
If your new dog/puppy is not housebroken, what method will you use to train it?
Will you keep the dog up-to-date on vaccinations/heartworm preventative?	Yes No
Who is your veterinarian? Phone.
Where will this dog be kept during the day? During the night?
If you go away for a few days, or on a vacation, who will take care of the dog?
If you move, will you take the dog with you?	Yes No
Have you ever applied to adopt an animal from Mutt Madd-ness in the past? If so, when?	Yes No
Did anyone refer you to Mutt Madd-ness? If yes, please explain.	Yes No
Are you willing to allow a Mutt Madd-ness representative come to see where the dog will be living?	Yes No
Are you willing to take the responsibility for this dog for the next ten to fifteen years?	Yes No
For which of the following reasons would you give up your dog?	Moving New Baby Not getting along with: Children Other pets Divorce Getting out of fence Behavior issues Financial	Aggressive Got too big Shedding Too time consuming Allergies Barking Medical problems None of the above
Thank you for completing your application with Mutt Madd-ness. By signing below, I am attesting to the truthfulness of my answers. Falsification or misrepresentation of the above information will result in rejection of this application or possible removal of adopted pet from my home. Signature (Name): Date: *Mutt Madd-ness reserves the right to refuse any applicant.*