Heart in Hand, Critters Hollow Rescue Dog Adoption Application

Heart in Hand, Critters Hollow Dog Adoption Application
Heart in Hand, Critters Hollow is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals. All Heart in Hand rescues are completely funded through fundraising efforts and public donations. All of our pets receive complete medical care, which includes worming, vaccinations and spaying/neutering prior to their adoption.
This questionnaire is designed to help Heart in Hand, Critters Hollow and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Heart in Hand, Critters Hollow Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!
Applicant Information
Name of the dog you are interested in:
Your full name:
Your age:
Street Address:
City, State, Zip
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:
Employer:
Character reference and phone number:
Household Information
Are all members of your household in agreement with this adoption?
Who will be the pet's primary caregiver?
Do you live in a

Other
Do you own or rent?
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?
Are there any restrictions from your landlord or subdivision?
Do you have a fully fenced yard?
Height and type of fence
Do you have any of the following?
How many adults are in your household?
How many children are in your household?
If children, what are their ages?
Have your children been around animals before?
Does anyone in your home have allergies to dogs or have asthma?
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages
How many of these pets are spayed/neutered?
Where are these animals now?
Have you adopted from an animal welfare group before?
If yes, what group?
Have you ever given up a pet?
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)
Are you aware of crate training?
Have you ever house-broken a dog or puppy before?
If the dog has an "accident" in your home, what type of correction do you plan to use?
How many hours each day will your new pet be home alone?
Where will your new pet sleep at night?
How will you supervise the dog's outdoor activity?
Where will your new dog stay when nobody is home?
What length of time will you allow your new pet to adjust to his new home?
Are you willing to work through your new pet's issues, if any?
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?
Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for?
Do you plan to take an obedience class with your dog?
If yes, where?
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?
What circumstances would lead you to give up your new dog?
If you had to give up your dog, what would you do with him/her?
How did you find out about Heart in Hand, Critter Hollow Ranch & Rescue?

Other
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Signature
Should be Empty:

Heart in Hand, Critters Hollow Dog Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information