Adoption Application
Adoption Application
First Name *
Last Name *
Email Address *
Street Address *
City *
State *
Use state abbreviation
Zip Code *
Phone Number *
No dashes, just digits.
What is the best way to reach you?
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Please list specific dogs from our website that you are interested in. *
What age of dog are you looking for? (select all that apply) *
Required
Would you consider adopting a mixed breed Australian Cattle Dog? *
What gender would you prefer? *
On average, how long will your new dog be left alone each day? *
Please check any following special needs you would consider adopting. *
Required
Why do you want a cattle dog? *
Required
How many adults live in the home? *
How many children live in the home? *
Ages of children?
What is your family's activity level? *
How many pets do you have? *
Age(s)
Breed/Species
Gender(s)
Are all of your pets spayed/neutered?
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All dogs and cats in the home must be spayed/neutered prior to adoption. Unless for medical reasons the dog or cat can’t be spayed Heeling Heelers Hearts will need to see documentation from a licensed veterinarian.
Are all of your pets current on their vaccinations?
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Please explain why your pets are not current on their vaccinations.
Have you ever had to relinquish a pet (take to pound, give to friends,etc.)? *
Please explain why you had to relinquish a pet.
Have you ever owned a Cattle Dog or mixed breed Cattle Dog? *
Please tell us your experience with the breed.
What type of home do you reside in? *
Do you own your home? *
If you do not own your own home, can you provide us with a letter from your landlord granting permission to own a dog prior to adoption?
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Is the backyard completely enclosed? *
What type of fence do you have?
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Do you have a pool? *
Is the pool fenced?
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Where will your new dog be kept while you are away? (check all the apply) *
Required
Where will your new dog sleep? (check all the apply) *
Required
We will not adopt to anyone that is going to keep their dog outside 24/7.
How will your new dog be transported in a vehicle? (check all that apply) *
Required
What would you do with your new dog in the case of a life altering event? This includes things like relocation, loss of employment, needing to provide hospice care for the dog, or development of dog allergies by a family member? *
What would you do in the case of an incident involving your dog? This includes things like the dog developing destructive behaviors, getting in a dog fight, biting someone, or barking excessively. *
Please provide the name and phone number of three personal references (that do not live with you) that we may contact.
Reference 1 *
Reference 2 *
Reference 3 *
We thank you for your interest in adopting one of our dogs. Our adoption coordinator will contact you within two business days to discuss your application and further steps.
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