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Dog Post Adoption Questionnaire

Your New Family Member's Name
Are you planning to change your new family' member's name? If so, please provide it.*
- Yes
- No
Pet's New Name*
Contact Reference
Who is someone we can contact who would always know where you are in case of an emergency with the dog?
Contact Name*
Contact Phone*
Contact eMail*
Vet Information
Please provide information for the Vet this pet will be seeing.
Do you have a local Vet yet?
- Yes
- No
Vet Clinic Name*
Vet's Name*
Vet's Phone*
Vet's Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

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Find Us

Cortez Rescue and Outreach, Main Facility - By Appointment Only
KM 91.5 MX HWY 1
Las Cuevas, BCS, Mexico

OR

"Mini" Cortez - By Appointment Only OR Scheduled Events... You can find our secondary, smaller facility a quick 20 minutes north of our Main Facility in the town of Los Barriles on Don Pepe road.

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Dog Post Adoption Questionnaire

Contact Reference

Vet Information

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