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Home / Adoption Form

Pet Adoption Form

Ready to Start? Fill Out The Animal Adoption Form below.

The first step towards adopting your new pet is to fill out our Adoptions Form below! You must live in MA, NH or CT to adopt with us at this time. We are a 100% volunteer-run organization and ask for your understanding as we may take more than a couple days to process your applications. You can find the details on what to expect after you fill out your application and our complete animal adoptions process here.

Also, due to the Covid 19 Pandemic, applications for animal adoptions have increased drastically. Our amazing adoption coordinators are processing your applications as quickly as possible. We thank you for your patience. You can find more information on how the pandemic has affected the adoption process here.

  • Adopt a dog
  • Adopt a cat

1Adoption Application Form - Dogs
2About the pet
3References
4Authorization
Safe With Us is only able to adopt to residents of MA, NH and CT. I am a resident of one of these states.

Primary Applicant information

Contact information for the primary applicant

Co-applicant information

Contact information for the co-applicant

Primary applicant information

Back to the primary applicant
Please include the applicant and co-applicant name
Under 18's
Check our website for the current adoptable pets.
Please note, we may may have multiple applications for individual pets!
If the dog(s) you are interested in are no longer available for adoption, would you like us to continue to process your application for pre-approval in the event that another dog interests you?
Please describe the traits (temperament, size etc) you are looking for in a pet.
Please include name, animal (cat/dog), breed
Please list each pet and describe their temperament, and if they are fixed or not (spayed/neutered).
Please include: name, age, M/F, Fixed, still have; if no why?
Puppies and adult dogs may need obedience, behavior and other training, in one on one, group or other settings.
Major life changes such as changes in work or work schedules, divorce, changes in living situation etc happen. What will happen to your dog?

Veterinarian contact information

Current, or prior veterinarian contact details. If this is your first pet, please use N/A.
Name of pets (as they appear on vet records)
Name of owner of pets, per vets records

Personal reference #1

At least one reference must be a non family member
How long have they known you, and in what capacity?

Personal reference #2

At least one reference must be a non family member
How long have they known you, and in what capacity?

Personal reference #3

At least one reference must be a non family member
How long have they known you, and in what capacity?

Adoption Application Agreement

I, the undersigned, understand that this is a basic application for adoption of a pet under the care of Safe With Us Animal Rescue. I understand that an application must be processed, which includes but is not limited to, reference and vet checks, and a home visit. I understand that an adoption of a pet requires full completion of the process and that filling an application out does not guarantee me the pet that I am interested in. Likewise, filling out an application does not mean that I have to adopt the pet that I am interested in.
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1Adoption Application Form - Cats
2About the pet
3References
4Authorization
Safe With Us is only able to adopt to residents of MA, NH and CT. I am a resident of one of these states.

Primary Applicant information

Contact information for the primary applicant

Co-applicant information

Contact information for the co-applicant

Primary applicant information

Back to the primary applicant
Please include the applicant and co-applicant name
Under 18's
Check our website for the current adoptable pets.
Please note, we may may have multiple applications for individual pets!
If the cat(s) you are interested in are no longer available for adoption, would you like us to continue to process your application for pre-approval in the event that another cat interests you?
Do you have a gender preference?
Please describe any color, breed or similar preferences
Please describe any temperament or personality preferences
Please include name, animal (cat/dog), breed
Please list each pet and describe their temperament, and if they are fixed or not (spayed/neutered).
This can take several weeks
Major life changes such as changes in work or work schedules, divorce, changes in living situation etc happen. What will happen to your cat?

Veterinarian contact information

Current, or prior veterinarian contact details. If this is your first pet, please use N/A.
Name of pets (as they appear on vet records)
Name of owner of pets, per vets records

Personal reference #1

At least one reference must be a non family member
How long have they known you, and in what capacity?

Personal reference #2

At least one reference must be a non family member
How long have they known you, and in what capacity?

Personal reference #3

At least one reference must be a non family member
How long have they known you, and in what capacity?

Adoption Application Agreement

I, the undersigned, understand that this is a basic application for adoption of a pet under the care of Safe With Us Animal Rescue. I understand that an application must be processed, which includes but is not limited to, reference and vet checks, and a home visit. I understand that an adoption of a pet requires full completion of the process and that filling an application out does not guarantee me the pet that I am interested in. Likewise, filling out an application does not mean that I have to adopt the pet that I am interested in.
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Adoptable animals
Pepper & Pebbles
Pepper & Pebbles
Meet Pebbles and Pepper!! These sisters are approximately 14 weeks old, and are lab/pittie mixes...
Hallie
Hallie
This sweet senior girl is looking for her forever family. She is 10 years young,...
Wilma
Wilma
Meet Wilma!! This 11 week old pittie mix is simply adorable! Wilma and her siblings...
Betty
Betty
Meet Betty!! This 16 week old pittie mix is simply adorable! Betty and her siblings...
Lora
Lora
Meet Lora!! She weighs around 40 pounds and has a super soft, short brownish-black coat....
Bindi & Beaux
Bindi & Beaux
Meet Beaux and Bindi!! They are five month old pittie/retriever mixes. Beaux is a male...

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