Leopold's Perfect Pup Adoption Application www.LeopoldsPerfectPup.com 860-668-7525 860-995-5542
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Last Name
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Zip Code
Phone Number
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Are you over the age of 24?
yes
no
Occupation? Hours away from home?
Veterinary Reference
Clinic Telephone
Personal Reference
Telephone
Do you Rent or Own your Home?
Own
Rent
If renting Landlord's Name and Telephone
Other Pets with Name, Breed, Age
Will this Pet be Crated/Caged and for how long?
Children Name and Age?
Will they be supervised with Pet?
Have you ever owned a Chihuahua and are you aware of the needs of this Breed?
Is your yard fenced?
yes
no
Do you live on a main road?
yes
no
Will this animal be used for anything more than a household pet?
no
yes
Are you financially capable of providing rountine medical and dental care for this pet?
Do you agree to spay/neuter this pet as soon as possible?
yes
no, I intend to breed this dog
already altered
Do you have any concerns regarding this adoption?
Under what circumstances would you be unhappy with this pet/adoption?
Do you agree to allow periodic follow-ups on this pet?
yes
no
Do you agree to return this pet to Leopold's Perfect Pup under any circumstances if you no longer want this animal?
yes
no
Other Comments:
Adoption Preference
puppy
adolescent
adult
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