FOUR STEPPING STONES RESCUE 
                                       Phenix City, AL / www.4SSRescue.com /4ssrescue@gmail.com

 ADOPTION APPLICATION                                                                            Revised 4-22-24
The questions on this Adoption application are designed to help you and 4SSR make the best possible choices in adopting a lifelong companion to fit your home and lifestyle. We place all of our pets in foster homes ASAP. If we do have to place them in a kennel temporarily, until a foster can be found, we place them with a trusted  facility where they receive socialization and daily exercise. We have a certified dog trainer who works with 4SSRescue and the dogs to offer training and advice on each dogs needs.  We love our pets and put a lot of time and effort into learning their individual needs and personalities. We will only adopt to homes that will make this Pet a part of their Family.  Please answer all questions honestly and completely. All applicants must be over the age of 18. Thank you for your time, understanding and consideration in completing this application.
This is the first step in our adoption process. We will be verifying all of the information on this application including calling your veterinarian, your landlord (if applicable)  and your personal references. We will then do a phone interview with you. At that time we will ask any questions we have and answer any that you may have. The next step will be to schedule a home visit to be sure the dog will be a good fit for your family and life style.   If everyone agrees at the home visit that your family and life style will be a good fit, the adoption can be completed!
Sign in to Google to save your progress. Learn more
Email *
How did you hear about Four Stepping Stones Rescue? *
Today's Date  *
MM
/
DD
/
YYYY
What dog are you interested in Adopting? *
Your Full Name

 *
Date of Birth
Month, Day and Year
 *
MM
/
DD
/
YYYY
Drivers License or State Issued ID
Issuing State and Full Number
 *
Phone Number
The Best Number to Reach You. Please include Area Code.
 *
Alternate Phone Number 
Including Area Code
Home Street Address 
No PO Boxes or Mail Pick Up Facilities
 *
City, State, Zip Code *
How long have you lived at your Current Address? *
Do you: (Please check all that apply) *
Required
Do you plan on moving in the future? If yes, please explain. *
If you do move, will the pet be able to move with you? Please explain. *
The home environment is: *
Are you currently: *
Does your chosen occupation require you to travel or move? If Yes, how often? *
Where will the Pet be kept during the day and at night? Please explain in detail. *
Do you have a fenced in yard?

 *
If you do not have a fenced yard how will the pet be  kept safe when outdoors? Please explain

 *
Are there any restrictions IE: Breed, Weight or other Restrictions from your Landlord, Homeowners association or Homeowners Insurance? *
Your Landlords Name and Phone number with area code

Please list the ages of any Children living in your home OR that will have regular contact with the pet.


 *
My primary interest in in adopting this pet is as: *
Who will be the primary care giver of daily needs for this pet? IE; Taking out to potty, feeding, exercise... What is their relationship to you? *
What Pet Food will you feed this Pet and why do you choose to feed this Brand/Type? *
Is everyone residing in your home in agreement about adopting a new Pet to bring into your home? *
Does anyone living in your home have allergies or other sensitivities to animals?  *
Please list ALL Pets currently living with you
1) Pets Name
2)Type of Pet (IE; Cat, Dog, Pig, ???
3) Male or Female
4) Age of Pet
5) Approximate weight of Pet
6) How long has this Pet resided with you?
7) Does this Pet live indoors, Outdoors or both?

 *
Are all Pets in your home Spay/Neutered?  *
How is a new dog introduced to your current pets and  how do they react when a new dog comes into your home?
 *
The average life span of a dog is 15 years. Are you willing to provide a loving, responsible home for the lifetime of this Pet? *
To the best of your knowledge has anyone who will have regular contact with this pet ever been charged with a crime involving an animal?
 *
Do you have a plan in place for Vet Care? Please consider that Emergency Vet Care can be very expensive.  *
If this Pet becomes severely injured or sick I will get this Pet needed Veterinary care and I will be responsible for the cost of the care. *
Veterinarian Information
Name of the Clinic where your pets have been seen. If you are a first time pet owner, please enter N/A.
 *
 What is your Veterinarians name?
Vet Clinic's Street Address
Number, Street, City, State and Zip Code

 *
Clinic's Phone Number
with Area Code
 *
What is the name on the account at the Vet Clinic? *
Do you have experience with administering medicine to a pet? Please explain: *
Will you administer Flea, Tick and Heartworm Preventative to this pet Every Month? *
The average length of time Pet will be left at home alone will be: *
When the Pet is home alone, he/she will be: *
When going out of town for business, emergency, or vacation what arrangements will be made for the care of the pet while you are away?
 *
On a daily basis what type of exercise will your Pet participate  in?  Please check all that apply *
Required
What qualities are important to you in a dog? Please check all that apply *
Required
Please explain your preferred method of training for your Pet(s). Do you use any training devices such as a Clicker, a Shock Collar, Exc? *
If this Pet has a potty accident or chews something you left accessible to the Pet, please explain in detail how you would address this behavior.  *
I understand that it may be stressful for a Pet to move to a new environment and he/she will need time to decompress. How will you allow this Pet to decompress? Please explain:
 *
When fully grown the best size Pet for my home will be: *
Please explain in your own words why you would like to adopt this Pet including your hopes and expectations. *
Are there any Pets that you have owned in the past 5 years that no longer live with you? If yes, please explain. *
I understand an agree that if for any reason I can no longer keep this Pet I will contact 4SSR and give them sufficient time to make arrangements for the Pet to be reclaimed into 4SSR.  *
I agree that a 4SSR Representative may visit my home for a welfare check of this Pet at a reasonable hour for the lifetime of this pet without prior notice. *
Reference #1 Not living with you and known for a minimum of one year.
1) Name
2) Telephone Number including Area Code
3) Best time to call
4) Relationship to you IE: Friend, Coworker, or...
 *
Reference #2 Not living with you and known for a minimum of one year 
1) Name
2) Telephone Number including Area Code
3) Best time to call
4) Relationship to you IE: Friend, Coworker, or...
 *
  I understand that completing this application is the first step in the adoption process. 4SSR has the responsibility to place each Pet with the best fit and the right to deny any application at their discretion. I confirm that the information I have provided is true and complete to the best of my knowledge. I understand 4SSR may contact the references and numbers I have provided on the application.  I understand that there are no guarantees to the health or temperament of any Pets placed, however, 4SSR makes every effort to learn the health, temperament and preferences of the Pets while in our care and provide detailed and accurate information about all Pets in our Rescue. 
While participating in the 4SSR adoption process I agree that I, my heirs, executors, legal representatives, and administrators will not make a claim against or bring suit against 4SSR, it's directors and volunteers for injury or damage resulting  from negligence, being active or passive, or other acts, however caused by any 4SSR directors, volunteers or animals. 
 *
Please enter today's date AND type your full name below to be submitted as your legal signature. Then scroll to the bottom of the page and click the red [SUBMIT] Button. You will receive a "Your response has been sent" message. If you do not receive this message, please email us at 4SSRescue@gmail.com. Thank You! *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms