Lavender Haven Sanctuary and Rescue Dog Application

I am interested in adopting:*

How did you hear about this dog?*

Why do you want to adopt this dog?*

Full Name*

Age*

Street Address*

Home Phone

City,State,Zip*

Cell Phone*

Employer*

Email*

example@example.com

If you are not the primary income earner, who is?*

Relationship:*

Employer:*

Provide contact numbers for all adults living in your home.

	Name	Age	Relationship
1
2
3
4

Have you considered all costs involved with owning a dog/another dog?(vet care, emergency care, dental care, vaccines,

food, flea/tick/worm preventative, rental deposits, grooming, training, etc*

Are you financially capable of providing for all of the dogs needs and future needs?*

Are all the members of the household wanting to adopt this dog?*

Is anyone allergic to dogs?*

How many hours a day are you away from home?*

Where will the dog be when you are away from home?*

How much time will the dog be in your company?*

How much time are you willing/able to spend per day walking, playing and interacting with this dog?*

Who will be caring for this dog? Feeding/watering, waste clean up, grooming, etc?*

Where will the dog spend the majority of its time?*

Are you willing to give this dog a forever home and care for it for 15+ years?*

Have you ever given up a pet?*

If yes, why? And what happened to it?

What do you hope to gain from bringing a new dog into your home?*

Sometimes unforeseeable circumstances arise. What scenario would make you give up your dog? example birth of a baby, medical emergency, moving etc.*

What type of training do you plan to use?*

What are your opinions on disciplining your dog?*

Opinions on choke collars and shock collars?*

If your dog develops an expensive or difficult medical condition, what will you do?*

Are you willing to let us visit your home to verify a safe living environment?*

Where do you live?*

Do you rent? Do you have permission from your landlord to own a dog?*

Landlord’s name and number:

How long have you lived at your current address?*

Do you plan to move?*

Is your yard fenced?*

If so, what kind of fence? (height, material)

If not, how do you plan to keep your dog safe and provide appropriate exercise ?

Do you plan to use an outdoor kennel?*

Do you plan to use a crate?*

Do you plan to tie this dog outside?*

Do you plan to use a cable runner?*

What brand of dog food and treats do you plan to use?*

Where will the dog sleep at night?*

What kind of flea/tick preventative do you plan to use?*

Do you have any livestock at your address? chickens, horses, etc*

If yes, will they interact?

Do you have a way to keep them safely apart?

List all pets currently living at your home

All Household Pets*

	Name	Species	Breed	Age/Time in your care
1
2
3
4
5
6

Are all pets spayed/neutered? If no, why?*

Past pets If you have never owned your own pet you can use family pets.

Past Pets*

	Name	Species	Breed	Age/What happened
1
2
3
4

Please give your vet clinic permission to speak with us about your account. If this is your first pet please list what vet clinic you plan to use.

Vet clinic:*

Address:*

Phone Number:*

How long have they been your vet?*

Previous Vet?

Phone Number:

Please give your references notice that we will be contacting them. We need 3 references. Only one relative please.

Name:*

City/State:*

Phone Number:*

Relationship:*

Name:*

City/State:*

Phone Number:*

Relationship:*

Name:*

City/State:*

Phone Number:*

Relationship:*