The first step in the process of adopting a pet from Lily's Pad Rescue is to complete this form expressing interest in adopting one of the dogs available for adoption.In working with you, we will be able to determine if the adoption is in the pet's best interest, and the process ensures that you will find a pet well-suited to your lifestyle.

Our adoption fee includes the cost for vaccinations and other medical care; the spaying or neutering of the animal; and any other considerations needed for the dog. If the pet you have chosen has not yet been spayed or neutered, you may be able to take it home with you, but this will require you to sign an Early Release agreement with Lily's Pad Rescue, a binding legal document that commits you to sterilize the pet at an appropriate age.

To qualify for adoption, you must:

Have a valid driver's license or state Identification Card stating your current address
Have the knowledge and consent of a landlord, if relevant
Be able and willing to spend the time and money necessary to provide medical treatment, proper nourishment and care, and training for a pet.
Provide detailed information for all questions

We reserve the right to refuse adoption to anyone. Please be advised that we will not adopt to persons who mislead or fail to provide complete accurate information on this application.

Please provide the name of the dog you are interested in being considered for. If you are not applying for a specific dog please designate 'best match'
Name *
Address *
Best contact phone *
Best contact phone
Home Information
Do you live in a
Do you own or rent *
If you rent, please provide: Landlord's name Landlord's phone number Description of the rules governing pets
Do you have a fenced yard? *
Household Information
Does anyone in the house have a known allergy to dogs? *
Is everyone in the house in agreement with the decision to adopt a dog? *
Pet Information
Please specify type, number, age, size and temperament
Are these pets up to date on vaccines? *
Are these pets spayed/neutered? *
Have you ever surrendered a pet? *
Have you ever had a pet euthanized? *
Have you ever lost a pet to an accident? *
Vet Information
Please provide the information for your current veterinarian or the name of the vet you plan to use for this dog
Clinic phone *
Clinic phone
Adoption Information
What type of dog (s) are you interested in giving a permanent home? *
Please select all that apply
What is your desired level of activity with the dog? *
Please select all that apply
What are your preferences in a dog? *
Please select all that apply
Care Information
When left alone inside the house, how will your pet be kept? *
When left alone outside the home, how will your pet be kept? *
Do you agree to provide regular health care by a licensed vet? *
Do you agree to keep the dog as an indoor dog? *
Are you willing to let a representative of Lily's Pad Rescue visit your home by appointment? *
Name and relationship to applicant please
Name and relationship to applicant please
Training and Behavior
What behaviors or characteristics would pose a major problem within your household? *
Please select all that apply
Would you consider training classes or obedience classes? *
About You
Provide name, address, phone, email, description of relationship (relative, friend, neighbor, etc)
Terms and Conditions
The above statements are true to the best of my knowledge and I agree to the terms above *
I understand that by typing my name in this field I am acknowledging that these statements are true and that LPR may contact my veterinarian and references.
Date Submitted *
Date Submitted