Adopt – Rainbow Bridge Hospice Rescue

Applicant First & Last Name *

First

Last

Spouse/ Co-Applicant *

Single
Married
Co-Applicant

Spouse First & Last Name

First

Last

Co-Applicant First & Last Name

First

Last

Email *

Phone Number *

Address *

Address Line 1

City

State

Age of Applicant *

Age of spouse

Age of co-applicant

Do you have any children living at home? *

No
Yes
Plan on having children someday

Please list the names and ages of the children.

Does anyone else live in your home? *

Please list their names and ages.

Does any household member suffer from asthma or allergies? *

Please describe the allergies/asthma.

What type of home do you live in? *

Do you rent or own? *

Rent
Own

Have you received approval from your landlord to have an animal? *

Landlord First & Last Name

First

Last

Landlord Phone Number

Is your back yard and/or front yard fenced? *

Is there a chance you may move within the next 10 years? *

Are you willing to restrict your choice of housing to places where a dog is allowed?

Which dog(s) are you interested in? *

What traits are you looking for in a pet? *

Where will the dog be kept? *

Where will the animal sleep at night? *

Where will the animal be kept when you are not home? *

What ongoing behavior, if not fixable with time, could you not tolerate in a dog? *

Are you willing to work with the dog to correct these issues? *

If you become unable to care for your pets, what would be the plan for their future? *

Under what circumstances might you want to rehome the dog? (Examples: Marriage, new baby, divorce, behavior issues, financial stress, job change etc.) *

Veterinarian's Name and Phone Number (or N/A if you do not currently have a vet, or have not had one recently). *

Do you have any pets currently? *

Please list name, age, sex, species, and breed.

Are your current pets on heartworm and/or flea preventative? *

Are your pets current on all shots? *

Are your pets spayed/neutered? *

List all the pets you have owned in the past 10 years and what happened to them: *

Where do your currently owned dogs stay when you are not home? *

What do you enjoy most about dog ownership? *

What do you like least about dog ownership? *

Please list the names and email address or telephone number of 3 references not related to you. If you do not currently have pets under vet care please provide a fourth reference. *

Please list the names and email address or telephone number of 3 references not related to you. If you do not currently have pets under vet care please provide a fourth reference.

Name *

First

Last

Phone

Name *

First

Last

Phone

Email *

Name *

First

Last

Phone

Email *

Signature *

Clear Signature

THE NEWEST MEMBER OF YOUR FAMILY IS READY TO COME HOME

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© 2026 Rainbow Bridge Hospice Rescue

ADOPTION APPLICATION

THE NEWEST MEMBER OF YOUR FAMILY IS READY TO COME HOME

NAVIGATE

SERVICES

CONTACT

© 2026 Rainbow Bridge Hospice Rescue