Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Adoption Application We use email almost exclusively to contact applicants. Please make sure we have good contact information. Contact Information Name *FirstLastEmail *Cell Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHouse Information Do you own or rent your home? *ownrentIf you rent, please provide your landlord's contact informationDo you have a doggy door? *NoYes, does not lockYes, lockableDo you have a fenced in yard? *No fenceNo fence, dog park on or near property (for renters/condo)Fence, wood/metal less than 4 footFence, wood/metal 4 foot or higherFence, electricAny comment about the fence?Do you have a pool or hot tub? *No pool or hot tubPool or hot tub with no fencePool or hot tub with fence that dog would not be able to enter pool areaAny comment about the pool or hot tub?Co-applicant Information Co-applicant NameFirstLastCo-applicant Cell PhoneHousehold Information Please list everyone in your household and their ages (include yourself). *If you have children in the home, or who visit regularly, please tell us about their experiences with dogs. *Do you work outside the home? How long are you gone during the day? How many days a week? *Animal Care Information Please list your animals, breeds, size, and ages *Please list any previous animals, breeds, age and date of passing *Have you ever returned a dog before? If yes, please explain. *Have you ever bred a dog before? *YesNoDo you use heartworm preventative and flea/tick for all your pets? *YesNoN/APlease provide name of heartworm preventative and flea/tick control you currently use.Are all your pets spayed/neutered? *YesNoN/APlease provide current veterinarian address and phone number. *Please provide previous veterinarian address and phone number if less than 3 years with current veterinarian. *By submitting this application, you give permission to retrieve information from your veterinarian. I understand that my vet will be contacted to provide information about my current and/or previous pets. *I understand and agree.Dog Information Which dog(s) are you interested in? *What dog food do you currently feed? *How will your new dog fit into your lifestyle? *Are you looking for a low, medium or high energy dog? *Low Energy - only serious couch or lap potatoes please!Medium Energy - Walkies, playful, but cuddly too!High Energy - Loves to run, play, fetch, goes full on til its time to sleep!I'm open to anything!Will you leash walk you dog? *YesNoOtherParagraph TextWill you allow your dog off leash outside of your fenced yard? *YesNoOther:Paragraph TextHow will you introduce your dog to your family, friends, and pets? *What do you consider to be unacceptable behaviors in dogs? *How would you deal with these behaviors in your new dog? *Does your home have steps? Please tell us how many and where (inside, etc.). *Do you allow your current/previous dogs to go up/down your steps? *YesNoN/AWhere will your new dog sleep? *How long will your dog be left alone during the day? *Never1-2 hours2-4 hours4-6 hours6-8 hoursLonger than 8 hoursWhere will your dog stay while you are gone?Free run of the houseCrateGated in a roomOther:Paragraph TextWhere will your dog stay when you go on vacation? *Do you have experience with Dachshunds? *Are you familiar with IVDD in dogs? *YesNoOther:Paragraph TextIf you have had a dog with IVDD, please tell us what treatment options you pursued.Personal References Please provide contact information for two references not related to you. Reference #1 Name *FirstLastReference #1 Email *Reference #1 Phone *Reference #2 Name *FirstLastReference #2 Email *Reference #2 Phone *Anything else we should know? *By submitting this form you give permission to retrieve information from personal references, and also acknowledge that as part of our process a home visit (either in person or virtual) will be made. *I understand and agreeSubmit
