Adoption Application

Adoption Application

PLEASE BE ADVISED THAT BY FILLING OUT THIS APPLICATION IS NOT A GUARANTEE OF ADOPTION. WE RESERVE THE RIGHT TO REFUSE ANY ADOPTION THAT WE FEEL WILL NOT SUIT THE DOG'S REQUIREMENTS.
Interested Dog(s) Name:*
Applicant's Name*

First NameLast Name
Age*
Occupation*
Please be specific
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Relationship Status*

SingleDatingMarriedOther
Significant Other's Name

First NameLast Name
Significant Other's Age
Significant Other's Occupation
Significant Other's Number

Area CodePhone Number
Significant Other's Email
example@example.com
Number of Adults in the home*
Who are the other adults in the home?*

My/Our adult childrenParentsSiblings/Cousins/Family etcRoommatesOther
Kids in the Home (Full or Part time)*

YesNo
If Yes, how many and what are their ages?*
EX: 3 - 10, 14, 17
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Dwelling*

Single Family HomeCondo / TownhomeTravel Trailer/RVApartmentOther
Own or rent?*

OwnRent
If you rent, do you have permission from your landlord to have a dog?*

Yes, we have his/her permissionNo, but we can get permission immediately.Other
Landlord's Information*
EX: John Smith, # & email
Does your home have stairs?*

No, we do not have stairs.Yes, we have a flight of stairs.Yes, we have stairs but the dog will not use them.Other
Do you have a fully fenced in yard or patio*

YesNoOther
How high is your fence?*
Do you have a pool in your yard?*

Yes, I have a fenced in pool.Yes, but my pool is not fenced in.NoOther
Are you planning any vacations or business trips in the next 1-4 months?*

NoYes, and my dog will come with me.Yes, I have a dog sitter ready.Other
Please tell us about your/family lifestyle and anything else you think we should know. *
Current Pet(s)/Land Animals

This includes: chickens, sheep, goats, ducks etc.
Do you currently have another pet?*

YesNoOther
What are the pet(s) name(s), sex, breed, ages, fixed?*
ex: Bailey - F - Poodle - 4-yes
Is your pet used to other pets?*

YesNoOther
Your pet's details (Scared, nervous, hyper, easy going etc.) *
ex: My dog is reactive to other dogs on a leash.
How do you plan to discipline your pet and why? (describe)*
ex: Spank, place outside
What kind of dog food do you use? *
ex: Just 4 Dogs
Where does the pet stay (be confined) while you are out?*
ex: roams the whole home, crated, secluded
Number of hours (average) pet(s) spends alone*
ex: 8 hours
What other species of pets/ livestock/ working animals do you have?*

CatsBirdsChickens, ducks, geese etc..RabbitsHorses, goats, sheepOther
How will you teach your new dog to get along with all of the animals?*

I will trainThey will not be around each otherHire a trainerI do not know.Other
Do you have a regular veterinarian?*

YesNo
Clinic Name*
Clinic's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Clinic's Telephone*

Area CodePhone Number
Do you have a groomer?*

Yes, we have a personal groomer.Yes, we go to PetCo/PetSmartNo, we would love a recommendation.I will bathe/groom the dog myself.Other
When you go on vacation/out of town, who will watch your dog? (Click all that apply)*

Dog sitterFriend/FamilyBoarding FacilityThe dog will go with meOther
Have you ever had to relinquish a dog? If yes, why?*
Ex: The dog would pee in the house.
Have you ever had to euthanize a pet? If so, why?*
Sick, Cancer, Behavior
Are you aware that dogs should have ALWAYS wear an updated ID tag, and must be licensed and MUST be worn at all times?*

Yes, we ALWAYS keep our information updated.No, we take off their collars and harnesses while at home.Other
Are you aware that after the initial investment, that a dog can cost roughly $1,000.00/year.*

Yes, we are prepared for this responsibility.No, I did not know that but I am able to provide completely for the dog.Other
Are you prepared to have this dog for it's lifetime. A lifetime could be 10-20 years.*

Yes.No.Other
Your Potential New Dog
What kind of dog are you looking for? *
ex: Breed, size, gender, age etc.
What is the reason you would like to adopt a dog? *
Who will have primary responsibility for this dog's daily care? *
My husband, myself etc..
Who will be financially responsible for this dog? *
Myself, my son, my husband etc.
Under what circumstances would you relinquish your pet back to our rescue? (Click all that apply)*

AllergiesBarkingCannot go up/down the stairsChewing on furnitureDiggingDivorce/Break Up.Doesn't like cats or the cat doesn't like the new dog.Housetraining issues.I wouldn't give up my dog, ever.Kids lost interestLost homeMovingNew BabyThe resident dog did not get along with the new dog.The dog became ill and cannot afford vet careToo expensive to maintain the dog.Unable to pick up the dog.Other
Everyone in the home agrees to adopting a new dog?*

Yes, everyone is in agreement.No, everyone is NOT in agreement.Other
Will this dog be a gift/present?*

Yes, this dog will be a gift/present.No, this dog will not be a gift/present.
What if the dog was to get sick and it cost over $2,000? *
ex: Credit cards, savings account
If you were to become too ill or to pass away, who would become responsible for the dog? *
Wife, daughter, son, TWEH Poodle Rescue
Have you ever lost a dog?*

Yes, and was returned successfully.No.Other
Is there anyone in the home that can easily trip and fall because of the dog and get seriously hurt?*

Yes, elderly parent(s)Yes, myself/spouseYes, my childrenNoOther
Do you have time, and will you make the commitment to train your new dog should behavior concerns arise?*

YesNoOther
Where will the dog spend the day/night at? *
Bedroom, crate, patio, garage, patio, couch
Would we be able to come to your home and do a home check?*

YesNoI live out of the county of San Diego, and I am more than happy to send videos and pictures of my home.I am able to provide a home check pictures & video.Other
Please provide 3 references. Yes, we will call them all.*
ex: Christina A - 760-555-7896- Sister
Have you ever adopted from a rescue? If yes, please provide the name of the rescue, who you adopted from them and their contact information.*
ex: Christina A - 760-555-7896- Sister
Have you ever been involved in a lawsuit or had to sue anyone? If yes, detailed information is needed on why and how that came about.*
I certify that the above information is true and correct to the best of my knowledge. I further agree that any adoption made on the basis of this questionnaire is null and void if any of these statements are untrue. I understand that TWEH Poodle Rescue's main concern is that all pets be properly cared for by their owners. These fees are necessary to offset the costs incurred related to rescue, care, and adoption. I understand that TWEH Poodle Rescue reserves the right to deny the adoption of any animal.
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Adoption Application

Current Pet(s)/Land Animals

Your Potential New Dog