Adopt a Senior Dog


Please answer the following questions honestly and thoroughly. Thank You.

Past dogs you have owned. How long? Where are they now?
Do you have a fenced in yard?
Do/did you treat your dog(s) with flea/heartworm preventative?
Where in your home is your dog welcome? (Will you confine them?)
Have you kept up to date on all vaccination with past and current pets?
If for ANY reason you cannot keep this dog, it is to be returned to 911 Rescue. Please initial here to show you understand and agree to this term of adoption.
What is your mobility level? Are you able to walk your dog daily?
Do you have any major medical problems that would prohibit you from properly taking care of a dog?
Do you have someone to care for your dog if you are temporally away?
Have you ever surrendered an animal? If so, why?
If you have children or grandchildren in your home, what are their ages and what experience have they had with animals? It is very important to involve your child in the training of your dog.
Veterinarianís Name
Veterinarianís Phone
Veterinarianís Address
Please provide the name, relation and phone number of three personal references.


  • 911 Dog Rescue Inc. relinquishes any and all responsibility of said dog once you take the dog into your possession. This includes but is not limited to furniture, home interiors, etc., or any behavioral issues.
  • 911 Dog Rescue Inc. reserves the right to perform a home check before an adoption is finalized and also at any time after the adoption is finalized. 24 hours notice will be given before a home check after a finalized adoption. If the pre-adoption home check is not up to par per Amy Beam, 911 Dog Rescue Inc. reserves the right to deny the adopters until the issues are resolved or deny them indefinitely. If a home check is performed after the adoption is finalized, Amy Beam will review any issues and the dog may be removed from the adopters if the dog is in danger. At that time, the dog will not be returned to the adopters and the adoption fee will not be refunded.
  • By signing, you promise to be a responsible pet owner by feeding and watering, flea treating and caring for your dog as it is going to be a part of your family.
  • Upon final adoption, you MUST have a county dog license and a SECURE name tag with your current home address and phone number.
  • All 911 Dog Rescue Inc. dogs have a Health Certificate and have been tested and are heartworm negative, rabies vaccinated (if proper age) and are up to date with shots. You will receive records upon final adoption. I do everything in my power to ensure the health of these dogs but I am NOT a vet and I cannot guarantee health.
  • For your protection, 911 Dog Rescue Inc. encourages a vet appointment be made with your vet within a two week period AFTER final adoption and IMMEDIATELY be put on heartworm preventative.

By signing below you agree to above terms and conditions:

Signature of Adopter

All money received from donations goes directly back into the rescue to pay for dog food, vetting, shots, spays/neuters, dog toys, treats, and anything else the pups may need. We are grateful to all those who support this effort.

Show Your Support With an Amy's Adoptables T-Shirt!

Buy a Tshirt to support Amy's AdoptablesMedium, Large and XLarge are $12.00 + $2.00 shipping
Plus sizes of 1X, 2X, 3X are $15.00 + $2.00 shipping

Please order your shirt via PayPal. Please specify that it is for a T-shirt and include the size. 

Please make sure I confirm your order. Thank you for supporting this cause! 100% of all proceeds go to the dogs!!