Hearts4Doxies Rescue
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Today's Date *
Dog's Name *
Dog Species *
Dog Breed *
Dog Age *
Dog Gender *
What is it about this dog that captured your attention? *
What can you tell me about this breed's mental and physical attributes and requirements? *
Have you owned this breed previously? *
Pet parent full name and name of partner (if applicable). *
Phone number *
Email address *
Street Address *
City *
State *
Who will have primary responsibility for the animal? *
Number of adults in household over 21. *
Age of all adults in household. *
Number of children in household. *
Age of all children in household. *
Do you have grandchildren? *
If you answered yes to the previous question, what are the ages of the grandchildren? Type NA if does not apply. *
If you have grandchildren, how regularly do they visit? *
If applicable, have children been taught to relate to dogs? Please describe experience. *
Number of seniors in the home. Are they used to dogs? *
Does anyone in your household have allergies? If yes, describe. *
Are you financially prepared to handle emergency pet services? *
Are you aware of associated costs such as food, medical, training, etc? *
What is your environmental type? *
What is your home type? *
How long have you lived at your current address? *
Do you rent or own? *
Does landlord approve pets? *
Landlord name and phone number. If none, type NA *
Square footage of home. *
Size of yard. *
Is the yard fenced? *
How high is the fence? If not applicable, write NA. *
Is fence to the ground? *
Are you planning to move within the next two years? *
If you are required to move in the future and cannot find a home permitting animals, what would you do? *
Describe your lifestyle *
Describe your home pace *
What is a convenient time for a home visit with you and your family? *
Do you want to adopt or foster? *
Why do you want to foster or adopt an animal? *
Do you have cats? *
If you have cats, how many? If not applicable type NA, *
Are your cats accustomed to dogs? *
Are your cats declawed? If so, why? If not applicable type NA. *
Are cats indoors or outdoors? *
Do you have birds, rabbits, chickens, fish, pocket animals or reptiles? *
If no animals at this time, have you had any in the past seven years? *
Do you have dogs now? *
If you have dogs now, how many, what breed, gender, spayed/neutered and age. Please list each dog on a separate line. If not applicable type NA. *
Why do you want another dog? *
Are your current dogs used to other dogs? *
What is your level of experience with dogs? *
Will your dog be indoors or out when you are not home? *
Where will your dog sleep at night? *
What rooms are off limits to the dog? *
What outside areas are available to the dog? Fenced yard, enclosed patio, courtyard, unfenced common area? *
Who has access to your yard? Gardner, Pool man. Neighbor. Utility. Other, please explain: *
How do you normally walk your dog? On leash. Off leash. *
When on leash, do you normally use: collar only, corrective collar, or harness? *
Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed and an animal that might be destructive at times? *
Where will your dog travel in your car? *
What brand of dog food will you feed your dog? *
Do you have a doggy door? If yes, what is your philosophy on these? *
Have you ever participated in special dog training? If so, what type? *
Are you willing to attend obedience training with your dog? *
Will all family members take part in training? If not, why? *
What form of exercise will you provide the dog and how often? *
How many hours per day will your dog be alone? *
Where will the exercise take place? In yard, walks around the neighborhood, dog parks, trails, etc. *
Have you used a dog walker or do you have day care available if the dog was to be alone longer than four hours - the maximum length of time a dog should be left alone? If so, please provide name and contact info. *
How often do you go on vacation and what will you do with your dog? *
What outdoor activities do you or your family engage in? *
Do you hunt? If so, how often and where? *
Do you or your household members smoke? *
What is your philosophy or method of training a dog? *
Do you know of any dog trainers or behaviorists? If so, please include company name. *
Have you ever owned a rescue animal before? *
Have you ever had a special needs animal before? *
Have you dealt with behavioral issues before? *
Have you crate trained an animal before? Was it difficult? *
Have you house trained an animal before? Was it difficult? *
If necessary, how will you discipline your dog? *
Describe your "perfect" dog - breed, size, age, sex, color, temperament. Perhaps one you have owned or seen. *
What are your expectations from your dog? *
What can you offer a rescued dog? *
Are all members of your household aware of plans to adopt or foster an animal? *
If something happens to you, who will care for your animals? *
For what reason would you return a companion animal? *
Have you ever volunteered for a shelter or other rescue group? *
Have you ever applied to other rescue shelters/groups? Which ones? *
How did you hear about this animal? *
If you wish to add anything or ask a question, please do so here.
Employment info - include partner info if applicable. Indicate place of employment, full time or part time, work hours and days, commute time. If retired, where did you work before retiring? *
Do you have a flexible work schedule? Yes or No (Please explain) *
Can you bring your dog(s) to work? *
Name of veterinarian, address and contact information. If none type NONE. *
Please list two personal references - name, phone number, relationship *
I hereby certify that all the information supplied on this application is true.
Enter your full name here.
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