Rehoming Application form

How did you hear about Gigi/Stevie?

Full Name*

First NameLast Name

Age

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?

YesNo

Do you have young children in your home, or who visit your home often?

YesNo

Please List any Pets you have Living or Deceased (Please include any experience you've had with rescue dogs)*

Do you have any experience with training, and if so what type?

Positive Re-enforcementFear Free TrainingOld School-Alpha Dog TrainingMilitary type/police dog training

Are you willing to work with a trainer to help foster a strong/positive relationship with you and the dog?

YesNo

If not, why?

Are you willing to work with some negative behaviors?

YesNoMaybe

Please describe the type of dog you are willing to adopt (Please include personality traits, energy level, activities you'd like to do with the dog) We always want to make sure we have the best fit for the dogs we rehome.

Are you willing to take your dog to yearly vet appointments and when sick or seeming not like themselves?

YesNo

Both Gigi and Stevie are crate trained. Are you willing to provide a crate for her?

YesNoMaybe

If No please explain

Are you willing and able to provide monthly flea/tick and heartworm preventative, such as Simparico Trio?

YesNo

We cannot guarantee that you will not see some regressive behaviors initially, as the dog gets used to her new home and surroundings. Are you equipped to train with love and patience?

YesNo

Have you had any experience with an emotionally or physically neglected or abused dog?

YesNo

If Yes please explain

Do you have a fenced yard?

YesNoPartial

How many hours a day would the Gigi or Stevie be left alone?

What are you plans to exercise your dog? Both physically and mentally?

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?

YesNo

Vet Reference: Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any NoodleDoodle's dog.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless NoodleDoodles and it's members from any claims, damages, costs, or actions incurred because of the care or actions of adopted dog.

I accept full responsibility for the dog(s) actions at all times, and release NoodleDoodles from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to have NoodleDoodles complete reference call checks and conduct a home visit inspection to be able to approve my application and placement of Gigi or Stevie.

I agree that if I'm unable to care for the dog anymore that I will return the dog to NoodleDoodles and try to give NoodleDoodles a 2 week period to try and find another suitable home for the dog.

Date

MonthDayYear

Your name*

E-mail

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