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Lead Me Home Rescue Adoption Form

At Lead Me Home Rescue we are committed to finding caring & loving homes for each and every one of our rescued dogs. If you are interested in adopting a dog, please fill out the adoption form below and someone will get back to you within next 48 - 72 hours. Thank You!

    Dog I'm Interested In

    Contact Information

    Phone Number should be entered as 555-555-5555
    Phone Number should be entered as 555-555-5555
    Please Enter a valid email address
    E.g. 3pm - 7pm Monday - Wednesday - Friday

    Work Information

    Please select your current employment status
    Please enter your current occupation
    Please provide us the name of your current employer
    E.g. Mon - Friday 8am - 5pm, etc.

    Home Environment

    Please attach photos of your yard and inside your home where the dog will be staying. Or email photos to leadmehomerescue@gmail.com. Add your name and the name of the dog you are wanting to adopt to subject line.
    Please Enter your landlords full name
    Enter your landlords phone number. E.g. 555-555-5555
    Please list ages of all adults(18 and older) besides yourself, currently residing in your home.
    Ages of ALL CHILDREN(18 and under) currently residing in your home.
    If more than 4 hours, do you have plan to ensure that the dog is care for?

    Current and Past Pets

    Have all your other pets, both past and present, been spayed or neutered?

    Veterinarian Information

    Personal References

    Please list two Personal References

    By submitting this application, I affirm that ALL information is true and complete and that no one in the household where the per will reside has ever been convicted of animal cruelty or abuse. I agree to give permission for a representative of LMHR to call the references and veterinary practices I have listed. I understand the LMHR reserves the right to deny any adoption application with or without disclosure of cause. I also confirm that I have read or been explained the deposit policy for the doc I am applying for. I understand that if any of the information provided in this application throughout the adoption process is found to have been falsified, m deposit will not be refunded.