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Hearts United for Animals
Pre-Adoption Application

Hearts United for Animals is determined to place each dog in the right home for that particular dog. We take lots of time to get to know each dog and can tell you in detail about their personalities.

Our adoption fee is $200 for dogs and $75 for cats. The adoption fee helps offset the cost of having the dog altered, vaccinated, tested for heartworms, microchipped and provided any other medical care necessary. It costs far more than $200 dollars to provide all the medical care that the dogs require before they are adopted. We do send dogs on airplanes to new homes if there are safe flights. The cost of the flight is additional to the adoption fee. The cost varies depending upon the size of the dog, the airline, and the the method of shipping. We use our own kennels so that you do not have to buy one but ask that they be returned as soon as possible.

First Name (*)

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Last Name (*)

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Address (*)

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City (*)

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State (*)

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Zip Code (*)

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Home Phone (*)

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Work Phone

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Cell Phone

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Email (Please furnish for faster communication) (*)

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Which HUA animal are you interested in? Or please list any preference you have in adopting a dog (age, sex, breed, personality).

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Why do you want to adopt a dog? (*)

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What do you think are the most important responsibilities of being a pet owner? (*)

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For whom are you adopting the dog? (*)

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Have you ever been owned a pet before? (*)



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If yes, please describe those pets that are currently with you (type, age, sex, altered status).

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If yes, please describe those pets that are no longer with you (type, age, sex, altered status).

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If yes, what happened to the pets who are no longer with you? Please be specific.

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Under what circumstances would you consider relinquishing a pet? (*)

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Please provide the name and phone number of the veterinarian for your pets.

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How much are you prepared to spend per year for dog care including food and veterinary care? Are you financially prepared for injury, accident or illness of a pet? (*)

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How many people reside in your household and what is their relationship (i.e. mother, father, brother, sister, roommate)? (*)

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Please state ages of all persons in the household: (*)

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Does anyone in your household have allergies? (*)



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Who will be responsible for feeding, housebreaking and training? (*)

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Do you own or rent your residence? (*)



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What type of home do you live in? (*)






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Does your residence have a yard? (*)



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Is a portion of the yard completely fenced with physical fencing so that a dog cannot get out?

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If yes, please state the size of the fenced portion.

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If yes, what type of fence?

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What portion of the yard is fenced? How high is the fence? Does a door from the residence open into the fenced yard?

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Is there a dog door and if so is it open or closed when the people are gone?

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Where will the dog stay during the day (inside, outside, both)? Please be specific. If inside the house, where inside the house? (*)

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Where will the dog stay during the night (inside, outside, both)? (*)

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How much time will the dog spend outside? (*)

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Will anyone be home during the day? (*)



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How many hours will the dog be left unattended? (*)

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Where will the dog sleep? (*)

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What do you intend to feed the dog? Please be specific regarding brands of food. (*)

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How will you housebreak the dog? (*)

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Please provide the company name, address and phone number for the place of employment for each adult in the household. (*)

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How frequently will the adults be gone away from home on business/ vacation/ trips? And where will the dog stay when you are gone? (*)

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How did you hear about Hearts United for Animals? (*)

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Reference Information

First Name (*)

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Last Name (*)

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Address (*)

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Phone (*)

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I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief. (*)

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Today's Date (*)

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If your application is successfully submitted, you will see a confirmation screen.

If you don't see that screen, please review your answers to make sure nothing was missed.

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