First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

Drivers license number

Are You a Monroe County, Ohio Veteran?

Who all lives in the home? Please provide name, age and gender of everyone. *

Does anyone in your home have allergies?*
Choose one: Yes No

Interested pet

Why do you want this pet?*

What other pets reside in the home? (How many? What kind?)*

Have you had pets in the last 10 years? WE DO NOT ADOPT WITHOUT A PRIOR VET REFERENCE.*
Choose one: Yes No

If these pets are no longer with you, please tell us why.

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

How long have you lived there?*
Choose one: Less than 1 year 1 year 2 years 3 years 4 years 5 -10 years 10+ years

Do you plan to move in the next few years?*
Choose one: Yes No

Do you live near a busy road?*
Choose one: Yes No

Do you have a fenced in yard?*
Choose one: Yes No

Please provide name and phone number of landowner/landlord if applicable.

Are there any breed restrictions in your area or by the landowner?*
Choose one: Yes No

If you rent, do you have permission from the landowner/landloard to have a pet?*
Choose one: Yes No Not applicable

Who is your current veterinarian? Please provide name and phone number. (We do vet checks) Also date of last visit. Most adoptions require that you have a vet reference. WE DO NOT ADOPT ANIMALS WITHOUT A PRIOR VET REFERENCE.*

Please list the names and contact information for 2 references.*

Where would this pet spend most of its time?*

How many hours a day would this pet be left alone?*

If the dog is not housebroken, how to you plan to handle this task?*

Who will be the primary caretaker?*

How many hours a day would you spend with this pet?*

What kind of responsibility do you feel pet guardianship involves?*

If you must give up your pet, what would you do?*

When adopting this pet, do you realize the health maintenance costs per year and will you be able to continue this for the health of your pet?*
Choose one: Yes No

*PLEASE NOTE:  A lot of the dogs at the shelter we have limited history on and the breed of the dog is not 100%.

One application per pet.

You must be 18 years of age to fill out this application

These pets that are up for adoption have been traumatized and/or abused and we try our very best to place them in loving forever homes so as not to add to the pet's bad experience.  We are an all-volunteer organization and sometimes it takes time to review applications.  Please be patient.  If you don't hear from us in a timely manner, please contact us. 

Crossed Paws Animal Shelter Dog Adoption Agreement

1. I agree to keep this dog as a pet and provide regular exercise. I understand that keeping this pet chained outside continuously is not acceptable.

2. I agree to ensure the health and welfare of this pet by arranging annual veterinary check-ups, vaccinations, deworming, and any other necessary care to sustain the pet's health and well-being.

3. I agree to surrender this dog to Crossed Paws Animal Shelter if CPAS deems it necessary for the health and welfare of the pet.

4. I agree not to sell, trade, or otherwise rehome this dog. If I can no longer care for or wish to keep this pet, I will return it to Crossed Paws Animal Shelter.

5. I understand that the temperament, health, trainability, and personality of this dog are not guaranteed. Crossed Paws Animal Shelter makes no warranties, expressed or implied, including merchantability or fitness for a particular purpose.

6. I release Crossed Paws Animal Shelter from all responsibilities or liabilities of any kind.

7. I acknowledge receiving a written health record from CPAS that includes vaccination, deworming, treatment, and spay/neuter information.

8. I agree to send updates and photos of the pet at least twice a year via Facebook, Messenger, text, or email.

9. I understand the current adoption fee for this pet is $150.

10. I understand I am entitled to a full refund if the pet is returned in safe, healthy condition within two weeks of this agreement. No refund will be issued after two weeks or if the pet appears abused or neglected.

11. If this dog has not received all vaccinations, deworming, or spay/neuter surgery at the time of adoption, I accept full responsibility for completing these veterinary requirements within the appropriate time frame. I will provide CPAS with the date of the veterinary visit so CPAS can confirm compliance.

12. Crossed Paws Animal Shelter reserves the right to deny any adoption application for any reason deemed fit, without explanation.

13. I certify that the information I have provided is true and correct. I understand that falsification of information will result in the denial of this adoption application.

14. By signing this agreement, I acknowledge that I have read and understood all terms and conditions. I am prepared to offer this pet a loving home for its lifespan and accept full responsibility as the primary owner.

Please type your name as your signature and date. *