Brave Dog Rescue Application

THIS QUESTIONNAIRE IS DESIGNED TO HELP BRAVE DOG RESCUE AND YOURSELF DETERMINE IF A SPECIFIC PET IS THE RIGHT ONE FOR YOU AND YOUR HOUSEHOLD. ALL ADOPTING AND FOSTERING PARTIES ARE REQUIRED TO COMPLETE THIS FORM. BRAVE DOG RESCUE RESERVES THE RIGHT TO DENY ADOPTION OR FOSTER PLACEMENT BASED ON THE ANSWERS TO THIS QUESTIONNAIRE AND/OR INTERVIEWS PRIOR TO ADOPTION OR FOSTER PLACEMENT.
Type of Application:

FosterFoster to AdoptAdoption
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?
Name of spouse (or partner if you reside in the same home) and their occupation:
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
Please list all other occupants in your home:
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
What outside areas will be available to your new pet?

YardPatioBalconyGarageOtherN/A
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 there gate/how many gates?
If gates, what is the height at their 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?

YesNo
If yes, is your pool gated?

YesNo
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.)
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.
Please list all current pets:
Please list all current pets:
How many pets do you currently have?
Are of these pets spayed/neutered?

YesNo
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?
Is there any piece of furniture your new pet will not be allowed on, specifically?
Are there any areas of the home your new pet will not be allowed?
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
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
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?
If dog, 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?
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 willing to live with hair on your furniture, stains on your rug, a warm body in your bed and an animal who might be destructive at times?

YesNo
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?
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 barkingDiggingBitingPoor watchdogDestructive chewingFinancial problemsEliminating indoorsGrowling at guestsExcessive billsSheddingYour new partner doesn’t likeAllergiesAggressive on leashNoneOther
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:
Please provide the full name/phone number of two personal references
I understand that a home check is required prior to adoption or foster placement and that a home check does not guarantee placement.
If adopting, I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
If fostering, I understand that this pet shall remain the property of Brave Dog Rescue, which shall retain full rights and authority over all decisions regarding his/her welfare. And that Brave Dog Rescue may remove him/her from my care at any time, for any reason.
If fostering, I understand Brave Dog Rescue will provide all food and supplies, including medical care for him/her. I further understand that, except in cases of a life-threatening emergency, I must receive prior consent from Brave Dog Rescue if he or she needs medical care. If a life-threatening emergency occurs, I will immediately seek medical care for him/her and notify Brave Dog Rescue.
I understand that this agreement is non-transferable and that I must return him/her to Brave Dog Rescue if I am no longer able to care for him/her. Under no circumstances will I give him/her to another party without Brave Dog Rescue's prior written consent.
I understand that this application becomes part of my contract should I adopt or foster a pet from Brave Dog Rescue.
RELEASE OF LIABILITY AND INDEMNIFICATION

Upon Placement
I understand that the ownership, possession and care of an any animal comes with inherent risks. I hereby acknowledge that I am adopting, fostering or otherwise caring for this animal voluntarily and I knowingly assume such risks. I release Brave Dog Rescue, its employees, agents and volunteers from any and all claims of injury or damage to person or property that arise from my possession of or interactions with said animal.
I understand that submission of this application to Brave Dog Rescue constitutes my agreement with all the above listed terms.
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CURRENT/PREVIOUS PET OWNERSHIP

RELEASE OF LIABILITY AND INDEMNIFICATION