Rescue Dog Adoption Application

Adoption Application

Cane Haven Rescue
Cane Haven Rescue is a non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals. Cane Haven Rescue is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes heart worm testing, vaccinations, spaying/neutering, microchipping, and starting on monthly prevention prior to their adoption.
This questionnaire is designed to help Cane Haven Rescue 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 consideration. Cane Haven Rescue reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!

While we absolutely DO read each submitted application, please understand that we will ONLY reach out to you if you are selected as a match for one of our rescue dogs. While we'd love nothing more than to respond to all applicants, we just do not have that kind of volunteer manpower here at our rescue.

We take our adoption screening process
VERY seriously and do our best to ensure that this home will be our rescue’s LAST home.

Please complete the application below for consideration.
Applicant Information
Name of the dog you are interested in:*
Your full name:*
Applicants must be over 21 years of age and not currently first-time students. Applications that are not fully completed, or untruthful, will be considered void. Your age:*
Street Address:*
City, State, Zip*
Cell Phone:*

Area CodePhone Number
Work 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?*

YesNo
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:*
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully secured fenced yard?*

YesNo
Height and type of fence
Do you have any of the following?

Underground fenceKennelDog RunElectric Fence
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?

YesNo
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Current/Previous Pet Information

Current pets MUST be UTD on yearly vaccinations, heartworm and flea prevention and have a documented history saying as much in order to be considered.
List any pets you own or have owned in the past five years, and their ages*
How many of these pets are spayed/neutered?*
What kind of heartworm and flea prevention is your pets currently on?*
Where are these animals now?*
Have you adopted from an animal welfare group before?

YesNo
If yes, what group?
Have you ever surrendered a pet?*

YesNo
If yes, what were the circumstances?
We require a documented history of yearly vaccinations, flea and heartworm prevention to be considered for this pet. Are your current pets UTD on yearly vaccinations, heartworm and flea prevention? We WILL confirm this with your veterinarian and ask for a reference. This is non-negotiable Please provide the clinic name, address and phone number of your current or late pet's veterinarian so we can confirm this. If current/prior pets are listed above and this question is unanswered, your application will be considered incomplete and therefore voided.*
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?*

YesNo
Have you ever house-broken a dog or puppy before?*

YesNo
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?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?*

YesNo
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 Cane Haven Rescue?*

FacebookFriend/Family MemberOther websiteOther
I understand that I assume full responsibility for the welfare of this pet from the date of adoption.
Name

First NameLast Name
Should be Empty:

Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information