First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Select Dog interested in Adopting*
Choose an animal: Dempsey Ebony Esmeralda Farrah Hannah Henrietta Ivory Jackson Lily Belle Lucky

Each of our pets is examined upon arrival and is provided with ordinary, or in some cases, extraordinary veterinary care. They are routinely monitored while awaiting adoption, but there is always a chance that an animal is incubating a disease without showing any clinical signs. Do you understand this?

Our adoption fee of $200.00 includes spay/neuter, if not already done; first vaccinations, for puppies or adults; routine worming, and any needed medicine the animal has received in our care. If you adopt a puppy, you MUST provide vaccinations until the pet is at least six months old! After that, yearly exams and vaccinations are required. Do you understand this?

IN THE EVENT THAT AN ADOPTION DOES NOT WORK OUT, ARF requires the pet be RETURNED so that we may re-home it. HOWEVER, 72 HOURS AFTER RECEIVING THE PET, PLEASE CONSIDER YOUR ADOPTION FEE A TAX-DEDUCTIBLE DONATION TO ARF. Do you understand this?

We will deliver your new pet and check out your facilities (complete a home visit) once the application procedure has been completed. ****ARF-LA,INC.RESERVES THE RIGHT TO REFUSE ADOPTION TO ANYONE **** In order to be considered, 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, support and care of a pet -have a fenced-in yard -All resident animals must be altered*, up-to-date on vaccinations, HW tested yearly and on HW preventative. Do you understand this?

Why are you interested in adopting a pet at this time*

Please List All the Pets You Currently and Have Owned in the Past, starting with the most recent ones: Give animals Name, Type/Breed, Age, how long owned, Spayed/Neutered, Where is /was pet kept, still own or what happened to pet Ex: 1) Fido, Dog, Lab, 7 yrs old, owned 5 yrs, neutered yes, lives out doors, still own 2) Lacey, dog, chihuahua, 15 yrs old, owned 15 yrs, not spayed, lived indoors, deceased heart disease.*

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence*
Choose one: Privacy Chain Link Invisible

What is the height of the fence*

List at least one reference (who is not a family member)*

Veterinarian's Name, Address and Phone Number (list all vets you have used).*

Do you own or rent your home*
Choose one: Rent Own

If you rent, please enter your landlord's name and phone number

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

How long have you lived at this address*

List all the people and ages that live in the home.*

Are there children in your household or who visit often? What are their ages?*

Do you or anyone in your home have allergies to animals?*

Who will be responsible for the care of this pet?*

Where will pet be kept during the day? At night? *

How many hours a day will this pet spend alone?*

Where will it be kept when alone? *

Are you familiar with the use of a dog crate to train the pet during your absence or at night?

Are you familiar with the leash and licensing laws of your community and the state of Louisiana?

May ARF make follow-up calls and/or visits

Why do you want a dog? (check all that apply)
Choose all that apply: Companion Company for other pet Gift Guard Dog House Pet

What will you do if your dog chews on furniture, shoes, siding or shows other destructive behavior? *

Are you familiar with heartworm disease?

What type of heartworm prevention medicine will you use?*

How will you keep your dog confined to your property? (check all that apply)
Choose all that apply: Chain Fenced yard In house Kennel Leash Patio Runner

How will you secure your dog when traveling in a vehicle?
Choose all that apply: Free in rear Pet taxi Ride in back of open pickup truck Ride in rear of SUV Seat belt harness

Have you ever sold, given away, or surrendered a pet to a shelter, rescue or any person? If yes, please specify why: *

Please tell us a little of your lifestyle, your family including any special activities in which your dog would be included: *

If and when you move, what will you do with your dog?*

Please tell us how you became aware of ARF-LA and its programs: *
Choose one: ARF-LA Adopter ARF-LA’s Web Site Adoption Event Facebook Friend or Relative Internet Search - Petfinder.com Veterinarian