ADOPTION APPLICATION: Email us at MiamiPetAssistanceCoalition@gmail.com after you submit your application. Otherwise, we will not know that it's been submitted.

Your Name: *

Address City, State, Zip: *

How long at this address? *

Daytime phone: *

Evening phone: *

Email: *

Emergency Contact: *

Emergency Contact Phone Number: *

If you are interested in adopting a specific animal you saw advertised with us, what is their name?: *

Own home? Rent? (If renting, please include landlord name and contact info. We will be verifying if your lease allows pets.) *

Does anyone in your household have allergies to dogs or cats? *

Children in the family? How many & what ages? *

If your children have not previously had companion animals, how do you plan to teach them to humanely care for a pet that is adopted to your home? *

Occupation & Place of employment: *

When can we coordinate a pre-adoption home visit? *

What pets have you owned before? What happened to them? *

Do you currently own any pets? If yes, list species, breed, name and age: *

Are all pets in your household spayed / neutered? *

Do your pets (or past pets) undergo an annual wellness exam at a licensed veterinary hospital or clinic? *

Who cares for your pets when you travel? *

Who would be responsible for your pets if you were to become incapacitated? *

REQUIRED: Veterinarian Name and Contact info (for current or past pets): *

If your pets do not regularly see a vet, how often do you feel a vetting appointment is necessary and under what conditions? *

Are your current (or past) pets up to date on heartworm preventative? Brand: *

How often are your pets tested for heartworm? *

Are your current (or past) pets on flea/tick preventative? Brand? *

Should your dog, in its lifetime, have any critical medical issues/injury and require surgery, or expensive treatment, what would you do? *

What do you feed your current animals? *

Are all your pets current on their vaccinations? (We will ask you to provide proof) *

If you own dogs, do they have current licenses (rabies tag) in the county in which you reside? *

Are you financially prepared to provide the necessary care for your pet including: proper food, vaccinations, flea & tick prevention, licensing, adequate shelter, and veterinary care for yearly check-ups, or an after-hours medical emergency or illness, which could cost $500 or more? *

How do you address the situation if your dog became agitated or aggressive towards another dog or guests at your house? *

Where will your pets spend most of the day? *

Where will your pets spend most of the night? *

Are you willing to commit yourself and your energies to this pet for its lifetime? *

What do you consider a good reason to give up your pet? *

Do you have a yard? If yes, approx. size? Is your yard fenced “dog secure”? If not, how will you “potty” your dog and keep safe when let out? *

(for CATS) Do you plan on de-clawing the cat you adopt? *

About how many daytime hours, per day, will you be able to be at home with your pet? *

Where will the pet have most of his/her exercise? How often? *

I am interested in the following pet__________________ because _________________________. *

Please contact one of M-PAC’s adoption coordinators to find out the adoption fee for the particular dog you are interested in. By signing below, I acknowledge that the information provided on this application is correct to the best of my knowledge. If at any time the information I have provided changes, I will provide the updated information to Miami Pet Assistance Coalition. Your signature indicates you accept to be bound by these terms.

Sign here: *

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Driver's License State & Number *

Date of Birth *

Date: *

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ADOPTION APPLICATION: **Email us at MiamiPetAssistanceCoalition@gmail.com after you submit your application. Otherwise, we will not know that it's been submitted.**

ADOPTION APPLICATION: Email us at MiamiPetAssistanceCoalition@gmail.com after you submit your application. Otherwise, we will not know that it's been submitted.