Adoption Request Dog Rescue Form

Complete our adoption request dog rescue form to apply for adopting a specific rescue dog from Lifeline Dog Rescue. Please enter information that is complete and accurate to ensure the best match for your situation.

IMPORTANT: Please read our Dog Adoption Process Steps on the main Adoption page BEFORE completing this form. Thank you.

Name (adoptive parent 1):

Email Address:

Your Age (parent 1):

Daytime Phone Number:

Cell Phone Number:

Name (adoptive parent 2):

Your Age (parent 2):

Daytime Number:

Cell Number:

Number of Children and Ages:

Confirm the following address is your home where the dog will live:

Yes No

Street Address:

City:

State:

Zip Code:

Type of Home:

Single Family Duplex Apartment Condo Mobile Home

Home Ownership:

Own Rent

Property:

Fenced Yard Open Yard No Yard

If fenced, approximate size of fenced area:

Location:

City Suburbs Rural

List of Current Pets (breed, age, gender):

List of Pet Preventative Medications (type, brand):

What other pets have you previously owned in the last 10 years?:

Name of Lifeline Dog Rescue dog you want to adopt:

Are you familiar with the Weimaraner or other breed chosen to adopt?:

Yes No

Do you crate your dog(s)?:

Yes No

Name of Veterinarian and Phone Number:

Recreation plans for your dog:

Walks Park Dog Park Swimming Boating Shopping Travel

Are you willing to take your dog for obedience training?:

Yes No

What hours would your adopted dog be alone?:

Where would your dog stay if no one is home?:

Where would your dog stay if the family travels?:

If later choosing to surrender the dog do you promise to return them to us?:

Yes No

How did you find Lifeline Dog Rescue?:

Our Website Facebook Twitter YouTube Flickr Google Friend Other

Will you grant permission for Lifeline Dog Rescue or their representative to visit your home?:

Yes No

Please explain why you chose this dog and their purpose in your family:

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