Dog Adoption Application

Please use an email that you check frequently to fill out our online adoption application. Applications take our Adoption Counselor typically 24-72 hours to process. You will be contacted by email or phone call; please check both your email and voicemail for potential messages.

Our adoption fees for adults range from $100-$300 and the range for puppies is $150-$300 (covers full vetting, spay/neuter, microchip, and care of the dog). Adoption fees are payable via cash, credit, or debit; we no longer accept checks. Fees will be paid at the time of adoption and may vary.

Submitting this application does not mean you are committing to a dog, nor does it guarantee you will get that dog. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle. A successful adoption depends on selecting the right dog for your household and a good understanding of the dog’s needs and care requirements. Please help us with this process by answering the following questions fully & completely. THANK YOU!

**Please note that any fields left blank will halt the application reviewing process.

Dog & Puppy Adoption Application 2023

Applicant Information

Adopter #1 Name(Required)
Adopter #1 Birth Date(Required)
Adopter #2 Name
(if applicable)
Adopter #2 Birth Date
(if applicable)
(if applicable)
(if applicable)
Home Address(Required)
Do you own or rent?(Required)
I/We live in(Required)

Household Information

Please list all 18 and older
Please list all 18 and younger
Do you have frequent visitors between the ages of...(Required)

Pet Ownership

Are your current pets up-to-date on vaccinations?(Required)
Are your currents pets spayed or neutered?(Required)
Vet Information(Required)

Home Life

When will you be ready to adopt a dog?(Required)
Do you plan on:(Required)
(select all that apply)
(including veterinary care, licensing, ID tags, food, toys, crates, training, pet sitting, supplies)
Do you have a yard?(Required)
If you have a vertical fence, what is your fence height?

Ideal Dog

What kind of dog are you looking for?(Required)
What energy level do you prefer?(Required)
Why do you want to adopt?(Required)
Check all that apply.
My adopted dog will:(Required)
Check all that apply
Grooming Needs:
Have you discussed this adoption with all the members of your household?(Required)

We will be speaking to all adult residents to confirm everyone is aware of this application process and wants to have a dog added to this family. Please do not submit this application if you are "trying to talk someone into" adopting this dog or think that "once they meet the dog they will change your mind" or "I'm getting this dog as a surprise birthday present for someone". In those circumstances, you are more than welcome to email us to discuss the dog, but we would like all adults in the home to be involved in the email discussion.
Please take time to think and be honest when answering the following. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog?(Required)
Do you plan on getting pet health insurance?(Required)
Are you committed to providing a responsible home for your pet's entire life? (could be 15 or more years)(Required)
Are you willing to sign a legal contract agreeing to pet owner responsibility(Required)
How would you prefer to be contacted reguarding application status?
If you are interested in a specific dog/puppy you can put their name here.

Required Acknowledgement

By my signature, I certify that the above information is complete and correct and that I am at least 18 years of age. I understand that completing this application does not guarantee I will be allowed to adopt a dog and that the application is a tool to help the Quincy Humane Society determine if this dog and my family are a good fit for each other. I understand that all dogs adopted from QHS will be spayed/neutered, heartworm tested, microchipped, and vaccinated prior to adoption. I authorize verification of all statements on this application, including but not limited to prior vet medical history. I understand that QHS has the right to deny my request for adoption. I understand that any misrepresentations may result in my not being approved and may lose the privilege of adopting an animal from QHS. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption. I understand that this application is the property of the Quincy Humane Society who reserves the right to share this information with other shelters and rescue organizations.
Consent(Required)
Reset signature Signature locked. Reset to sign again
Date of Application Submission(Required)
Reset signature Signature locked. Reset to sign again
(if applicable)
Date of Application Submission

 

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