Adoption Information To be filled out by the Breed Representative as part of the adoption Date MM slash DD slash YYYY Adopter Contact Information First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Adoption Date MM slash DD slash YYYY Date the dog is adoptedBreedCurrent Name of the DogDog DescriptionColoring, Special markingsAgeSexMale, Female, or Neutered/SpayedDog's StoryHow the dog came into rescueWellness CheckupVets Name, address and phone number. List resultsAltered? Yes No Overall MedicalCurrent medical status and any medications the dog is currently takingWeightCurrent FoodAmount fed and whenList how much food the dog is fed daily and how often they are fedTreats UsedList what kinds of treats the dog likes, how often and how much are given dailyMedicationsList all medications the dog is taking. How often and dosage.VaccinationsList each vaccination. When they are given and when they will need boostersMedical TestsList any tests done.TeethList the condition of the dog's teethPersonalityList dog's likes and dislikes. If they have any fears or behaviors that will need attention. If they like toys. How they get along with other animals. Where they like to sleep. How well they travel.Grooming NeedsMicrochipMicrochip number, company name, and contact information for the company. Inform adopter that they need to transfer their contact information for the microchip. Please have a dog tag made for your dog's collar with your name, city, state, and phone number. We recommend not imprinting the dog's name on the tag to help you prove ownership if ever needed. We also suggest you take your dog to your veterinarian for provide them with their medical records and verify overall health.MoreAll information you can give a new adopter is important. Even fun facts that you know about the breed is usefulBooks to ReadSpecial NeedsAdoption Donation AmountThank you so much for choosing 'rescue'. Your donation to Seattle Purebred Dog Rescue will help another dog in the future.Signature: AdopterSignature: Breed RepYour email to have this form delivered to your inbox Picture (if available)
