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Clackamas County Dog Services
Animal Adoption On-line Application

Thank you for considering adopting a pet from the Clackamas County Dog Shelter. Please complete this application. You must be at least 18 years old to adopt. This application is used as a tool to help find the best possible home for the animal and the best possible match for your home and lifestyle. * Required Fields are in bold.

First Name:
 Last Name:
Home Phone:
 Work Phone:
Address:
City:
  		Zip Code:
E-Mail:
Date of Birth: mm/dd/yyyy
Drivers License Number:
 State of issue and Exp. Date:
Are you applying for a particular dog?
Yes No
If yes, please enter the number you see on our web site for the dog
Do you:
Own Rent Other
If other, explain:
How long at current address?
If less than 6 months-previous address:
Will you be moving soon?
Yes No
Do you live in:
House Apartment Mobile Home Other
Landlord name and phone number (if you don't own):
Do other adults live in this house?
Yes No
Have they approved of this adoption?
Yes No
How many children live in this house?
 List the Children's ages who live in this house:
Where will this animal be kept during the day?
Where will this animal be kept while you are at work?
Where will this animal be kept in the evening?
Will this animal be:
Indoors Outdoors In/Out
How will you confine your new pet on your property?
Fence Dog Run Trolley Stake in the Ground
Why do you want to adopt a pet?
Do any members of your family have allergies to animals?
Who will be the primary caretaker of this pet?
Who are you adopting this pet for?
Yourself Relative Friend Child
How much do you anticipate spending yearly on a pet you adopt?
If your adopted pet becomes destructive or is not housebroken, what would you do?
Under what circumstances would you not keep this pet?
Please list the pets that you currently own or reside at your home. Include type of animal, male/female, Age, Current of Vaccines, currently licensed and where did you get this pet?
Please list the types and breeds of pets you've owned in the last five years. Include age, how long you owned, and where the animal is now.
Do you have a veterinarian? If yes, please provide your veterinarians name and address.

Return/Exchange Policy
If you are unable to keep this dog, you will be required to return the dog to our shelter.

You may return the dog within 90 days for a refund.

If you return the dog after 90 days, you will be required to pay a $40.00 surrender fee.

1. All dogs adopted from Clackamas County Dog Services are implanted with a microchip.

  • Registration of that microchip is a part of your adoption process.
  • The cost is $20.00.

2. If you move, what will you do with this animal?

3. Adoption from our shelter requires you to Spay/Neuter this animal, do you have any objections to this procedure Yes No
If you object, why?

4. Would you be willing to permit a visit by a representative of Clackamas County Dog Services: Yes No

5. Where did you hear about our adoption program?

Each application requires a $10.00 Non-Refundable deposit applied to your adoption fees when you find your perfect pet within 6 months of date of application. By clicking on "Submit" below, I certify that the above information is true and accurate to the best of my knowledge and that falsification of information can be cause for denial of my application.  I agree to sign and abide by the adoption agreement.