How did you find out about our rescue group?
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Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone Number
Email
Occupation
Birthday
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What are the pet(s) name that you are interested in?
Is there another adult in the household?
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Name & phone number of second adult in the household:
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Have all the adults in the house agreed to adoption?
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Do you have children in your household?
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If yes, please list the first name and age of each child?
If no, do you plan to have children in the future?
What would you do with your pet if/when you have a child?
Is anyone in the house allergic to animals?
If yes, how severe is the condition? Dogs or cats or both?
Does anyone in the house have asthma, COPD?
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If yes, how severe is the condition:
Do you:
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What type of home do you live in?
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How long have you lived at this address?
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If you rent, please provide the landlord's name, address, phone number and email address?
Does you landlord have a size limit for pets?
If yes, what is the size limit?
Does your landlord have any breed restrictions?
If yes, please list breeds restricted:
What would you do with your pet if you moved?
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List at least two references (non-family members) (i.e. neighbor, friend, someone who knows you well) You must include name and a phone number and/or email address for each reference:
How will you keep your pet confined to your property?
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Is your yard fenced? (Please Note: The majority of our big breed dogs require a fully fenced yard. However, exceptions MAY be made, depending on the specific dog.) NO ELECTRIC FENCES
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What type of fence do you have? *A fully fenced yard is preferred, but applications are not denied for this reason alone. Depending on the specific dog, adoption may still be possible.
Is your fence in good and working repair (i.e. are there holes the pet could get out of, a gate that is missing or does not work, electronic is working properly, etc?)
What is the height of your fence?
If no, please specify:
Is there a lock on the gate?
Why are you interested in adopting a pet at this time? Any special circumstances you want us to know about?
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Is this your first experience with this type of pet?
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Are you familiar with Bloat? Please explain:
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Please list all the animals that you currently own or have owned in the past 5 years. Must include: Name of pet; Breed & Weight; Age; Spayed/Neutered; Indoor or Outdoor pet; and Where is the pet now?
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Are current pets up to date on vaccinations (Rabies, Yearly Booster Shots, Heartworm Preventative and Flea/Tick Preventative):
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All the pets in my house are up-to-date on shots.
All the pets in my household are spayed or neutered.
If your pet becomes ill, can you afford the vet bill to treat them (possible $100-$500)?
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Have you ever given up a pet? (i.e. given to someone, surrendered to a rescue or animal control, euthanized?)
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If yes, please explain:
Are you familiar with heartworm disease?
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If yes, please explain:
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Would you like information regarding heartworm disease?
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Can you afford and will you provide monthly heartworm preventative for this dog? (Costs range between $150-$200 for a 6-month supply)
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Please provide your Veterinarian's name, Address and phone number:
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If your current vet has been your vet for less than one year, please provide your past vet information to include name, address and phone number:
Who in the household will care for the pet?
Are you prepared to allow a minimum of 2 weeks for the pet to adjust to your home?
Will the pet be kept inside, outside or both inside/outside?
How much time will the pet spend alone during the day?
Where will the pet be kept when you are home?
Where will the pet sleep?
Where will the pet be kept when you are not home? (i.e. working, on vacation, etc.)
Describe how you will train your pet:
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What traits are you looking for in a pet? (Please check all that apply)
How would you react should your pet show aggressive behaviors while eating, to a child or another pet? Please explain:
Are you familiar with the leash and licensing laws in your community?
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Checkbox 23
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I HAVE READ THE TERMS & CONDITIONS OF ADOPTION AND HAVE INDICATED MY AGREEMENT TO EACH. I UNDERSTAND THE RIGHTS AND OBLIGATIONS INVOLVED AND THAT FAILURE TO KEEP THIS CONTRACT MAY RESULT IN LEGAL ACTION AND I WILL BE RESPONSIBLE FOR ALL LEGAL FEES AND COURT COSTS INCURRED BY MUST LOVE DANES.
SIGNATURE:
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First Name
Last Name
DATE:
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PRINTED NAME:
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First Name
Last Name
