DOGS ABANDONED BY GISELLE’S LEGACY APPLICATION

THIS QUESTIONNAIRE IS DESIGNED TO HELP DABGL AND YOURSELF DETERMINE IF A SPECIFIC PET IS THE RIGHT ONE FOR YOU AND YOUR HOUSEHOLD. ALL ADOPTING PARTIES ARE REQUIRED TO COMPLETE THIS FORM IN ITS ENTIRETY. IF A QUESTION DOES NOT APPLY, PLEASE MARK N/A. WE RESERVE THE RIGHT TO DENY ADOPTION BASED ON THE ANSWERS TO THIS QUESTIONNAIRE AND/OR INTERVIEWS PRIOR TO ADOPTION.

We are not a not a 501c rescue. We are a group of volunteers trying to place these abandoned dogs in a loving home.
Name of the pet you are interested in:*
Your full name:*
Address*

Street

City, State

Zip Code
Home Phone:
Cell Phone:*
Email*
Your Occupation:*
Your Age:*
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
How many adults reside in your home?*
Please list all adults that reside in your home and their relationship to you:*
How many children reside in your home?*
Please list the first name(s) and age(s) of all children that reside in your home:*
If there are children that reside in your home, have they been around animals before?*

YesNoN/A
Does anyone in your household smoke? If yes, where do they smoke?*
Inside the home, an outdoor area or both
Is anyone in your home allergic to pet dander or have asthma?*

YesNo
What type of dwelling do you live in?*

HouseCondoApartmentOther
Do you own or rent?*

OwnRent
If rent, please provide the name and phone number of your landlord:*
Are there are any restrictions from your landlord, subdivision, or HOA?*

Number of petsSize or weight restrictionsBreed restrictionsNoneN/AOther
If other, please explain:*
What outside areas will be available to your new pet?*

YardPatioBalconyGarageOtherN/A
If other, please explain:*
Are all outside areas where your new pet will be allowed, fenced?*

YesNoN/A
What type of fence do you have?*

Chain linkConcrete/Brick/StoneWoodN/A
Height of fence at the lowest point:*
Are gates kept locked?*

YesNoN/A
Who else has access to the yard (Gardner, Pool man, Neighbor, etc?)*
Do you have a doggy door?*

YesNo
Do you have a pool?*

Yes/GatedYes/Not GatedNo
Do you keep rat poison in your home and if so, where?*
CURRENT/PREVIOUS PET OWNERSHIP
What is your primary reason for adopting a pet?*

Companion for you/your childrenCompanion for another petWatchdog
How would you rate your level of experience as a dog owner?*

BeginnerIntermediateAdvanced
Who will be the pet's primary caregiver?*
What kind of personality do you want your new pet to have? (i.e. calm, protective, energetic, couch potato, etc.)*
What kind of exercise and socialization plan do you have for your new pet? *
Please list all pets you have had as an adult, including their names, species AND breed, length of time they lived with you and what happened to them.*
How many pets do you currently have?*
Please list all current pets:
Please list all current pets:
Are all of these pets spayed/neutered?*

YesNoN/A
Are all of these pets current on vaccinations ?*

YesNoN/A
What will you do if your new dog does not get along with the other pets in the home?*
Who will groom your new pet?*
What brand and type of food will you feed (wet, dry, etc?)*
How many hours each day will your new pet be home alone?*
Where will your new pet stay when nobody is home?*
Who will take care of your new pet when you’re on vacation?*
Where will your new pet sleep at night, specifically?*
Are there any areas of the home or pieces of furniture your new pet will not be allowed in/on?*
If dog, will your new pet wear a collar with tags?*

YesNo
When will the collar be on? When will it be off?*
What will you use to walk your dog?*

Martingale collarSlip leadRegular collarChoke/pinch chainHarnessOff leashOther
If other, please explain:*
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
If dog, how will you train him or her?*

Firm verbal commandHit with newspaperClicker/hand signalsE-collarWon't trainOther
If other, please explain;*
How would you discipline your new pet if he/she misbehaves?*
What will you do if your new pet has a “accident” in your home?*
Do you plan to take an obedience class?*

YesNoNot sure
If yes, where?*
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?*
What will you do with your pet if your current relationship breaks up?*
What will you do if a new partner does not like or want your new pet in the home?*
What will you do with your new pet if you have a baby?*
Pets are an investment of time and money. Can you afford the medical care, grooming, proper diet, shelter and exercise for your new pet?*

YesNo
Are you aware that pets can live up to 20 years and are you prepared to make a long term commitment for the remainder of their lives?*

YesNo
Have you, or are you willing to make a plan for the continued care of your pet(s) should they outlive you?*

YesNo
What will you do with your new pet in the event that you are no longer able to care for them?*
What will you do with your pet if you move to a new place locally that does not accept pets?*
What will you do with your pet if you move out of the state? Country?*
Which of the following reasons might prompt you to give up your new pet?*

Excessive barking/cryingBitingDestructive behavior (digging, chewing etc.)Financial problemsEliminating indoorsGrowling at guests/stranger dangerCost of vet careShedding/AllergiesSeparation AnxietyAggressive/Reactive on leashResource guardingNoneOther
If other, please explain:*
If you had to give up a pet what would you do with him/her?*
Will you agree to consult with and pay for a trainer or behaviorist if problems do occur?*

YesNo
Please provide the name and phone number of your current veterinarian. If you do not currently have one, please list your last veterinarian:*
Please list two personal references including name, number and relationship to you:*
I understand that a home check is required prior to adoption and that a home check does not guarantee placement.
I understand that the references I have provided will be contacted by DABGL as part of the screening process.
I understand that this application becomes part of my contract should I adopt a pet from DABGL.
I understand that submission of this application to DABGL constitutes my agreement with all the above listed terms.
Date*

MonthDayYear
Date
Signature*

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Household Information

CURRENT/PREVIOUS PET OWNERSHIP