Adoption Form

Please select which dog are you interested in.

Add

If you have a second choice, please list their name here. If you do not have a specific dog you are applying for, please put "Unknown" or "UnDecided."

Name

Please ONLY type your FIRST and LAST name

Age

Street Address

City

State

Zip Code

Email

Cell Phone

Home Phone

Work Phone

Current Employer

Partner’s Name

Partner's Age

{name}

Partner’s Employer

Please list all other residents along with ages living in your home.

{name}

If you have children please list their experience with dogs.

{name}

If you do not have children currently, are they possible in the future? (this will help determine if your adopted dog needs to be child friendly.)

Do you have grandchildren, nieces, nephews or other children visiting your home?

Please describe the temperament and activity level you are looking for (i.e. Quiet, Active, Lap Dog, Talkative, etc…)

{name}

Please list current pets living in your home (name, age, breed, gender, weight, temperament). Please include all including those living outside (Chickens, goats, birds, etc….).

{name}

Please list any past pets that you have previously owned as an adult (name, breed, how they passed or why they are no longer living with you).

{name}

Do you use Heartworm?

Yes
No

Do you use flea/tick preventative?

Yes
No

What brand of dog food do you use or plan on using?

Are all of your current pets spayed or neutered? If not please explain why.

{name}

Do you plan on taking your dog to the vet for a yearly physical/vaccines & heartworm testing & blood work as needed?

Please list any health issues that any of your pets, past or present, have had & treatment used.

{name}

Current vet’s name, address phone number (please let them know we will be calling for a reference)

Previous Vet name, address & phone number

Have you ever owned a dachshund before?

Yes
No

How do you exercise or plan on exercising your dog? (leash, hiking, fenced yard, dog park, etc…)

Do you walk your dog with a collar or a harness?

Collar
Harness

Please describe your daily routine & what role your pets play in it:

{name}

How long will your pet be left alone on a typical day?

Where will your dog stay while you are not home?

Where will the dog sleep at night?

Where will your dog stay if you travel?

Where will your dog go if you move?

Have you ever bred a dog?

Have you ever lost a dog?

Have you ever surrendered a dog? If so why?

{name}

What might cause you to surrender your dog in the future?

Do you have a plan in place if you are not able to take care of your pet in the future?

Who will be responsible for taking the dog & contacting us if you cannot care for the dog?

(name, phone, relationship)

Are you prepared to provide training for your new dog if more is needed?

What type of home do you live in?

Do you rent or own?

Own
Rent

Do you have stairs in your home?

Yes
No

Are they gated for safety?

Do you have a doggy door?

Is your yard fenced?

Yes
No

Do you have a pool?

Yes
No

Any additional comments you would like to add about anything that you feel we should know?

Personal reference #1 (non-family) name, email, phone number

Personal reference #2 (non-family) name, email, phone number

I have read and agree to the Terms and Conditions in the link below:

https://bit.ly/3iaLmVa

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