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Dog Shelter Adoption Applications

Guernsey County Dog Shelter Adoption Form

Todays Date:(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Email(Required)

Name of the dog you would like to adopt.(Required)

Do you own your home?(Required)

Yes

No

Landlords Name(Required)

First Last

Landlords Phone Number(Required)

Do you have children in the home?

Yes

No

How many children?(Required)

Ages of children?(Required)

Is the animal being adopted for yourself?(Required)

Yes

No

Have you owned a dog before?(Required)

Yes

No

What breed(s)?(Required)

Do you currently have a dog?(Required)

Yes

No

What breed(s)?(Required)

Do you have a current dog license?(Required)

Yes

No

Whose name are the tags listed in?(Required)

First Last

Are your current dogs up to date on Dhlpp/Rabies Vaccines?(Required)

Yes

No

Is anyone in the home allergic to animals?(Required)

Yes

No

Are you willing to work on housebreaking and obedience?(Required)

Yes

No

Do you understand that it will take time for this animal to adjust?(Required)

Yes

No

Do you agree to give this animal time to adjust?(Required)

Yes

No

Do you have a fenced in yard or kennel?(Required)

Yes

No

How do you plan to exercise the dog?(Required)

Is this dog going to be kept outside?(Required)

Yes

No

What type of shelter is offered for the dog?(Required)

I agree that I will be responsible for proper care of this dog which includes: veterinary care, proper diet, grooming and proper exercise.(Required)

Yes

No

I am aware that from the time of adoption, I am responsible for any medical care the animal needs and that the Guernsey County Dog Shelter will not be responsible for any medical care or expense should the animal become ill.(Required)

Yes

No

Primary reason for wanting to adopt a dog?(Required)

Do you have a steady income and home to provide for the new dog?(Required)

Yes

No

Are you 18 years or older?(Required)

Yes

No

Do you currently have a vet?(Required)

Yes

No

Current name the Vet records are under.(Required)

First Last

Current name of dog(s)(Required)

Current Veterinarian’s Name(Required)

First Last

Current Veterinarian’s Phone Number(Required)

Please check with your Vet prior to submitting your application to see if they require authorization before releasing of records. If not able to retrieve records, we will move on to the next application.

Consent(Required)

I agree to the privacy policy.

By submitting this application, I acknowledge that all information on this application is true and correct. I understand that any misrepresentation of fact may result in refusal of adoption privileges to me. Please allow 48 to 72 hours for your application to be processed.

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Guernsey County Sheriff’s Office

601 Southgate Parkway Cambridge OH 43725
740.439.4455

Our Privacy Policy

Our Mission Statement

“It is the mission statement of the Guernsey County Sheriff’s Office to enforce the laws of the State of Ohio, to deter offenses against the public in the most efficient and cost effective manner.”