Adoption Information Adoption Information To be filled out by the Breed Represenitive as part of the adoption Date MM slash DD slash YYYY Name 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 adoptedBreed Current Name of the Dog Dog Description Coloring, Special markingsAge Sex Male, Female, or Neutered/SpayedDog's StoryHow the dog came into rescueWellness Checkup Vets Name, address and phone number. List resultsAltered? Yes No Overall MedicalCurrent medical status and any medications the dog is currently takingWeight Current Food Amount fed and when List how much food the dog is fed daily and how often they are fedTreats Used List 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.Teeth List 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.Some dogs have a possible lethal reaction to Ivermection. This is an old medication that was used for worms. DO NOT use any shampoos, flea collars, or any medications with Ivermection in it. Also never give your dog any raw hide treats. These can break up and get lodged in the dog's throat. 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 Amount Thank you so much for choosing 'rescue'. Your donation to Seattle Purebred Dog Rescue will help another dog in the future.Signature: Adopter Signature: Breed Rep Breed Rep email to have this form delivered to your inbox
