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

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 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

How long have they known you, and in what capacity?

Personal reference #2

How long have they known you, and in what capacity?

Personal reference #3

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.