Adoption Application - Oregon Dachshund Rescue, Inc.
Your Contact Info
First and Last Name
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Address Line 1
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Address Line 2
City
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State
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Zip
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Email
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Phone
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Name of dog you are interested in
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Please indicate the sex of the dog you are looking for
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Male
Female
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Housing
Which type of home do you have?
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House
Condo
Apartment
Mobile Home
Do you own or rent?
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Own
Rent
How many stairs are in the home?
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Please list all occupants of the home and their ages
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Are all family members in agreement about getting a dog?
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Yes
No
Where will the dog(s) sleep at night?
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In their own bed
In a closed off room
In bed with me
In a crate
Wherever they want
Please upload a picture of your fenced yard or email Jenell (jrangan@comcast.net) with more details.
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Please list all other pets currently in the home including breed, gender, and age.
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Behavior
Tell us about your experience with dachshunds.
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Are you familiar with the characteristics of the Dachshund breed?
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Yes
No
Are you aware that purebred Dachshunds are not the best choice for families with very young children?
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Yes
No
If applicable, what method will you use to housebreak or refresh the dog’s housebreaking skills?
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Rescue Dachshunds vary greatly in temperament, personality, and activity level. What characteristics would you find undesirable in a rescued Dachshund?
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Your Preferences
Would you adopt a dog that is 6 years or older?
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Yes
No
Maybe
Would you adopt a dog that has a history of abuse?
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Yes
No
Maybe
Would you adopt a dog that is not reliable with children?
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Yes
No
Maybe
Would you adopt a dog that has a physical handicap?
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Yes
No
Maybe
Would you adopt a dog that requires regular medication?
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Yes
No
Maybe
Would you adopt a dog that requires house training?
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Yes
No
Maybe
Could you consider adopting a pair of Dachshunds in the case of dogs that should not be separated and need to be placed together?
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Yes
No
Maybe
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Your Time
Where will the dog(s) be kept when you are away from home?
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How many hours each day will the dog be left alone?
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While you are home, the dog(s) will be kept:
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Inside
Outside
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Vet Info
Do you currently have a veterinarian?
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Yes
No
Will you take your pet for regular vet visits for shots and any other medical needs?
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Yes
No
If the dog were to have some unexpected and horrible health issue or accident, ie; being hit by a car what would you do?
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How much is the maximum you would be able to spend on a vet bill of this kind?
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Are you planning to buy pet insurance?
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Yes
No
Maybe
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References
Reference 1 name, email, and phone:
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Reference 2 name, email, and phone:
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Reference 3 name, email, and phone:
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Final Questions
Are you willing to allow a home check prior to adopting a Dachshund?
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Yes
No
Maybe
If the situation does not work out with your family and the dog, do you agree to return the dog to Oregon Dachshund Rescue, Inc. without question?
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Yes
No
Briefly explain the main reason why you want to adopt a Dachshund
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Reminders
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