Adoption Application

ONCE UPON A TAIL RESCUE

ADOPTION Application and Contract

Once Upon a Tail is a non profit rescue organization for homeless dogs, sick, and injured dogs. It is our goal to get these dogs healthy and place them in permanent, loving homes where every member of the household is committed to their lifelong care. If you are willing to take on this responsibility, please complete the application below. Your application will be reviewed, and if qualified, we will proceed with the adoption. If you have applied to adopt at a weekend adoption event at PetSmart or another location, this application will not be approved or finalized until the necessary checks can be done the following week. If you were allowed to take a dog home based on a preliminary review and your application does not pass final approval, you are required to return the dog to the rescue within 24 hours.

ADOPTION INFORMATION
• You must be 21 or have the consent of your legal guardian. Proof required.
• You must be willing to allow a representative of the rescue to make a follow-up visit in person or by phone. Random visits may be made anytime within the first 60 days of adoption.
• If all included services have already been completed at the rescue's Veterinarian, you must make a visit to your veterinarian within the first 30 days of adoption. If you currently do not have a veterinarian, you must establish one, bring the dog to it's first appointment, and contact us with the name & phone number of your new veterinarian within this timeframe.
• Adoption fees are fully earned by the rescue & non-refundable for any reason after 30 days.

DOG'S Name that you are applying to Adopt*

If name unknown, just type a brief description of dog.

How did you hear about this dog?*

SECTION 1 - PERSONAL INFORMATION

Applicant's Full Name*

First Name Middle or MaidenLast Name

Spouse or Co-Applicant's Full Name (if applicable)

First Name Middle or MaidenLast Name

Cell Phone # *

Enter Primary # if no Cell Phone

Secondary # (Home/other)

Home or Other #

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Email Address*

example@example.com

How long have you been at your current address?*

Please list # of Years and Months

Do you own or rent home?*

OwnRent

If renting, please provide landlord's name, website and phone # here.

What is your landlord's pet policy?

Select from drop down

If you lived at another address within the last 7 years, how long did you live at that address?

Please list # of Years and Months

Please list your complete prior address. If renting, please list the landlord's name, website and phone # as well.

Date of Birth *

Date

Are you under 21?*

YesNo

If under 21, Please list Name & Phone # of your legal guardian.

Are you adopting this dog for yourself and those living in your household ?*

YesNo

If not adopting for your household, who are you purchasing for and why?

Employer Name, Phone # & Occupation*

If not employed, please just note that here.

SECTION 2 - LIVING ARRANGEMENTS

If you have to move in the future where dogs are not allowed, what would happen to the dog?*

Under what circumstances or life changes have you had to, or would you have to give up a pet?*

Select ALL that apply from drop down

If you selected a response to the question above about having to give up a pet, you can provide additional detail here if you'd like to explain further.

How many people currently live or reside in the home?*

	# of Adults	# of Children	Ages of ALL Children in home	Is anyone allergic to dogs
Residents in home

What role with the adopted dog play in your life?*

Describe the activity level in your home?*

Where will your adopted dog primarily live?*

Please select an option from Drop Down

If Both, please explain with additional details

Whether you currently have children or not, what boundaries, if any, do you think should be set for children around dogs? *

How many hours per day will your dog usually be left alone due to work, school, etc?*

Select # of Hours

Will pet be crated?*

Select the most appropriate option

Do you have a fenced yard that is fully enclosed on all 4 sides?*

YesNoOther

If Yes, how tall is your fence?*

Select height from drop down

If Yes, what is fence material?*

Select all that apply from drop down list

SECTION 3 - TRAINING and COSTS

Owning a dog comes with some recurring monthly and annual expenses. Have you thought about those, and feel that you financially prepared to pay for these expenses?*

YesNo

Adopted dogs usually have some potty accidents in their new home for a short period of time. How will you handle this? *

Adopted dogs may need some additional behavior training, depending on their background and whether they were previously living in a home. What behaviors would you NOT be able to live with?*

Select ALL that apply from drop down

If the ADOPTED dog displays any of the behaviors you selected above, how will you handle it?

Are you willing and able to seek professional training for your adopted dog if needed?*

YesNoMaybe

*IMPORTANT - If you are considering adopting a PUPPY, we can't stress enough, that the puppy will only grow up to be a well-behaved adult dog, based on the time and resources you put into training them as a puppy. You MUST be prepared to teach them where to potty, what/when/where to eat, what to play with & chew on, what type of play is acceptable (no using their teeth), socialization with other pets & humans, basic obedience & manners, etc. Although foster families have started working on many of these items, puppies are not born with this knowledge, it must be taught at appropriate ages, and it takes time.

If you are considering adopting a PUPPY, please provide details about any experience you have had with puppies, as well as how you plan to handle training for your new puppy.

Have you ever had to surrender a pet you owned to any animal shelter including a "low" or "no kill" shelter?*

YesNo

If you answered "Yes" to surrendering a pet, please provide detail:

Have you ever lost a dog to accident or escape?*

YesNo

If you answered "Yes" to losing a dog to accident or escape, please provide detail:

SECTION 4 - HISTORY WITH CURRENT AND PRIOR PETS

When was the last time you owned a dog?*

Please list # of years/mos ago or "own one now".

How many Total dogs have you owned in your life?*

Enter #

How many of the total dogs owned in your life were puppies? *

Enter #

How many dogs do you currently own?*

Enter #

How many cats do you currently own*

Enter #

Do you currently own any other pets? If Yes, please list types such as Birds, Hamsters, etc.*

List types other than dogs & cats.

List of CURRENT DOGS you own that are living at your home, inside and/or outside.

	Current Dog's Name	Breed or Breed Mixes	Current Age of Dog	Is Dog Spayed or neutered?	Is Dog Up to Date on shots?	Is Dog On Year Round heart worm prevention?	Where does the dog primarily live?
Dog 1
Dog 2
Dog 3
Dog 4
Dog 5

If you indicated that a dog lives Inside & Outside, please provide details on when it is inside and when it is outside.

Current Pet(s) disposition and behavior towards other dogs? Please list any positive information or possible concerns if introducing a new dog to your current pets.

If you use heartworm prevention for your dog, what kind do you use, and where do you purchase it?

If you use flea prevention for your dog, what kind do you use, and where do you purchase it?

Please list the Name and Phone # to the Veterinarian/Vet clinic you use for your CURRENT PETS. If more than one is used, please list all of them. *NOTE: IF THE RECORDS ARE UNDER ANOTHER NAME, PLEASE ALSO PROVIDE THAT NAME. Please note that by providing this information and signing this application, you have agreed for the veterinary clinic(s) listed to provide us with information about your current and/or past pets and relevant medical history.*

Please list the information for any PRIOR DOGS you've had in the last 7 years, living at your home inside or outside. *Please list the most recent dog at the top & continue to list in date order.

	Prior dog's Name	Breed or Breed Mixes	Dog Age when you last owned	Where is Prior Dog now?	Spayed or neutered?	Kept Up to Date on shots?	On Yr Round hw prevention?	Lived inside or outside?
Dog 1
Dog 2
Dog 3
Dog 4
Dog 5

Please list the Name and Phone # to the Veterinarian/Vet clinic you used for your PRIOR PETS, regardless of how long ago. If more than one was used, please list all of them and which dog(s) they treated. *NOTE: IF THE RECORDS WERE UNDER ANOTHER NAME, PLEASE ALSO PROVIDE THAT NAME.

If there is anything else we should know about you, current or prior dogs, or your application, please enter it here.

AGREEMENT TO ADOPT

Adoption fee: PUPPY (< 1 Yr)=$325, ADULT = $275, SENIOR (10 Yrs +) = $200 Included cost of spay/neuter, microchip, heart worm & microfilaria test (if dog over 6 months upon intake), initial fecal test & deworming, heartworm prevention until adopted, vaccines and examination by a licensed veterinarian, and any other services completed prior to adoption. If any of the services listed above have not been completed by the time of adoption, they must be scheduled and completed at an approved and participating Once Upon a Tail veterinary facility.

Please consider making an extra donation to help cover the cost of medical expenses for the many sick and injured dogs taken in by the rescue.
All original medical records will be transferred to adopter. It is adopter’s responsibility to maintain these records in a secure place for future reference.
Should all records not be available at time of adoption, the rescue will promptly mail to adopter once received.
If during the 3 day trial, you decide the dog is not right for your family, Once Upon a Tail agrees to issue refund, provided that you contact us during that 3 day period and make arrangements to promptly return the dog on the date and to the place designated and agreed upon by the rescue. The Vet information Packet and Rabies Tag (if issued) must also be returned in order for a full refund to be processed.

PLEASE READ CAREFULLY TO UNDERSTAND WHAT YOU ARE AGREEING TO!

By entering his/her signature below, the ADOPTER hereby agrees to the following terms and conditions:

On the effective date of this adoption agreement, Adopter assumes complete & total liability for the adopted dog. I agree to hold Once Upon a Tail and it's officers and directors, harmless for any financial, medical or legal liability associated with the dog.
Adopter acknowledges that Once Upon a Tail is providing an animal for adoption on an "AS IS" basis. Once Upon a Tail cannot guarantee breed mix or age, and is providing it's best estimate based on experience and veterinarian estimation. Once Upon a Tail makes no representation as to the temperament or medical condition of the dog being adopted. All medical records received by Once Upon a Tail are provided to adopter.
If Adopter chooses to have the animal checked by their own licensed veterinarian, it is at their own cost. Any medical issues which may be present shall be brought to the attention of Once Upon a Tail within 30 days of adoption, who may, at its own discretion, assist in the treatment process. Upon request, Adopter will provide Once Upon a Tail with proof of the required vet visit.
Adopter shall allow a representative of Once Upon a Tail to visit/check on the dog on a random basis during the first year of adoption & to notify Once upon a Tail of any change of address during this time period. Should Once Upon a Tail find that the dog is not being cared for in compliance with this agreement, or in violation of local or state laws, Once Upon a Tail reserves the right to seize the dog for the safety & welfare of the dog.
Adopter shall provide for the dog's physical and emotional needs including: proper diet & nutrition, housing, exercise, medical care, vaccinations, & monthly heartworm preventative for the remainder of it's natural life.
Adopter shall comply with all state and local laws pertaining to the care and keeping of the dog, including leash laws, licensing, registration and rabies vaccinations.
Adopter agrees that the dog will be kept as an Inside Dog, and be taken outside only with supervision for exercise, play and potty needs.
Adopter agrees not to abandon, give away, sell or trade the dog for the duration of the dog's natural life. Adopter agrees to contact Once Upon a Tail in the event that the dog cannot be kept due to unforeseeable circumstances in the future. Should re-homing be necessary, it must be done in conjuntion with the rescue. Under no circumstances will the dog be sold, returned to PetSmart or any other adoption event facility, nor surrendered to a shelter or other rescue group.
Adopter agrees to make every reasonable effort to locate the dog should it escape or become lost or stolen, including contacting Once Upon a Tail as soon as possible. Once Upon a Tail will provide information and/or assistance to help locate the missing dog.
It is a requirement of this Rescue that ALL animals adopted be spayed or neutered by 6 mo of age. If you have adopted a puppy too young for this procedure, you will be required to have this done at an approved and participating Once Upon a Tail Veterinary facility. If the adult dog you have adopted has a scheduled spay or neuter appointment, you are required to honor this appointment. If an appointment has not been scheduled or has not been done due to the health of the dog, you will have 45 days after the adoption to have this procedure done at one of the rescue's approved clinics. Should the animal not be altered prior to this date, you are in violation of this contract and the rescue will take the necessary steps to reclaim the dog.
Puppies require a series of booster shots spaced 3 weeks apart. This is included in your adoption fee. The 1st set of shots is given @ 6 weeks of age, along with the initial fecal test and deworming. All subsequent fecal tests and deworming medication, if needed, are the responsibility of the adopter. Should the adopter choose to have the remaining shots at another veterinary clinic other than the one approved by the rescue, payment responsibility is that of the adopter. Adopter must submit proof to Once Upon a Tail that this service was performed within the proper timeline. By signing I understand what services are included in the adoption fee and that the cost of any other service or medication is my responsibility.
Microchip must be done with a chip provided by the rescue, so that in the unfortunate event that the dog is lost, it will also be tracked back to Once Upon a Tail Rescue. It is included in the adoption fee, but should I choose to have the microchip done elsewhere, I must contact the rescue to obtain the proper chip, and pay an additional $5 additional fee for rescue to ship & process the chip. The cost of implanting the chip elsewhere, is also the responsibility of the adopter.
If all included services have already been completed at the rescue's Veterinarian, I must make a visit to my veterinarian within the first 30 days of adoption. If I currently do not have a veterinarian, I understand that I must establish one, bring the dog to it's first appointment, and contact the rescue. with the name & phone number of my new veterinarian within this timeframe.
If I return the dog for any reason, whether at my request or the request of the rescue, I understand that I must return the dog, along with the Vet Information Packet and Rabies Tag (if provided), before my refund can be processed.
If I am allowed to take an animal without pre-application approval as a "Foster to Adopt", I understand that I must pay the standard adoption fee as a deposit until the application is approved. I understand that Once Upon a Tail Rescue will complete all reference checks, request photos and a possible home inspection, the following week. If my Application does not pass the Approval Process, Once Upon a Tail reserves the right to reclaim the dog. Should this occur, I agree to promtly return the dog to the rescue within 24 hours of initial notification.
If Once Upon a Tail discovers any detrimental or false information received regarding the welfare of this animal or if we feel the placement is incorrect at any time, Once Upon a Tail reserves the right to reclaim the animal. Should this occur, I agree to promtly return the animal it to the rescue within 24 hours of notification.
I understand that Adoption fees are fully earned by the rescue & non-refundable for any reason after 30 days.
Should adopter pay with a check and the check is returned for Insufficient Funds or any other reason, the adopter agrees to immediately replace with Cash, Money Order or Venmo, including a $30 NSF Fee.
If Once Upon a Tail deems it necessary to use an attorney to enforce the terms of this Agreement, Adopter shall be responsible for payment of attorney's fees, court costs, and/or fines necessary to enforce this Agreement.

I, the undersigned Adopter, having read and acknowledged the terms and conditions of this Agreement, understand I will receive a copy of the Terms, Agreement and all medical records available for the animal I have chosen to adopt.

Effective upon the date of Contract, I, the Adopter, assume complete liability for the animal and agree to hold Once Upon a Tail and it's officers and directors, harmless for any financial, medical or legal liability associated with the animal.

I agree to abide by all conditions listed within this Agreement and to maintain contact with Once Upon a Tail during the first year of adoption to help ensure a smooth transition of this dog to my family.

I certify that the information provided on this application is complete, true and accurate to the best of my knowledge. I understand that providing false information may void this application and result in forfeiture of the adopted animal, as well as any adoption fees paid.

Signature*

Clear

Signature*

Application Date*

Date

FINAL INSTRUCTIONS:

Please double check that you have completed all required fields and then click the SUBMIT button below. You will see a screen with a GREEN CHECK MARK when the application is submitted successfully. If the application is not submitting, please scroll up and complete any missing information in red, and try to submit again.

THANK YOU FOR YOUR SUPPORT OF OUR RESCUE AND THE DOGS WE DEDICATE OUR LIVES TO!