Adopting person(s) agrees to contact the above stated rescue immediately if the rescue dog is lost or stolen.Yes
No
If I am approved, I agree to the following adoption requirements (please select yes or no):
Adopting person(s) agrees that the rescue dog will be a house pet and will receive all care and attention necessary to ensure its health and well-being. Adopting person(s) will provide adequate food, fresh water, shelter, exercise, veterinary care (including yearly inoculations and monthly heartworm prevention) as recommended by attending veterinarian, and license said dog in accordance with State and Local laws.Yes
No
Adopting person(s) agrees to purchase Heartworm preventative for the rescue dog (i.e. Interceptor, Heartguard, Sentinel, Revolution) within two weeks of agreement date and to keep the rescue dog on the preventative for the duration of the rescue dog’s life.Yes
No
Adopting person(s) will not permit the dog to run free or off-leash or out of immediate control. When outside, the dog will never be staked or chained.Yes
No
Adopting person(s) will provide indoor (not garage) sleeping quarters. Yes
No
Adopting person(s) will not transport the dog in an open pickup bed or boat.Yes
No
Adopting person(s) agrees that the dog will, at all times, wear a buckle collar with current rabies tag.Yes
No
Adopting person(s) will contact above stated rescue at least one week prior to any change of address. Yes
No
Adopting person(s) will keep the rescue dog for so long as it shall live and will not transfer the ownership to any other person, firm, corporation, or organization for any reason.Yes
No
If custody of the rescue dog must be relinquished, adopting person(s) agrees to notify the above stated rescue immediately to arrange for its re-adoption. Yes
No
The adopting person(s) takes the rescue dog as is, with all conditions either observable or unobservable and assumes full risk for the dog from the date of signing an adoption agreement. Yes
No
The above named rescue has discretion in the refund of the adoption fee in part or in entirety at anytime after the adoption has taken place. Yes
No
Adopting person(s) agrees that any rescue dog adoption is contingent upon the completion of a home visit, with the rescue dog present, by a Hounds Haven representative. Adopting person(s) acknowledges and agrees that if the Basset rescue volunteer (in its sole discretion) determines that any violation of the above conditions exist, the above names rescue is authorized to immediately retake custody of the dog. Yes
No
Date of Application
Which Hound(s) are you interested in?
Name(s) of Applicants
Address
City, State, Zip
Home Phone #
Cell Phone #
Work Phone #
Preferred time to Reach You
Email Address(s)
Other People in Home(Names, Ages **PLEASE INCLUDE CHILDREN**)
Are all Adults in agreement of Adopting A Basset
Age of Consenting Adults?
Occupation(s)
Rent or Own???
If Rent...landlords Name and Phone #
How long have you lived at Current Residence??
Fenced in Secure Yard??
If you do not have a fenced in yard, do you agree to keep Basset on secure tie-put at all times while outdoors??**Please Note we do not absolutely require a fenced in yard...we however do place certain in hounds in fenced in yards only for thier safety**
Where will the dog be kept during the day?
Where will the dog sleep at night??
How many hours will the dog be left alone??
Where will the dog be when you are gone?
When you go on vacation where will the dog be??
Who is your Vetrinarian(Name, Address, Phone #, Name used on the account) **please note if you have just moved but have an exisitng pet we will NEED the contact information for the vet in which you last used**.
May we contact your veterinarian to confirm your existing animals health?
How much are you willing to pay in vet bills in a year?
Have you ever owned a Basset Hound before??
If Yes what do you feel are thier best traits?
If no, why did you chose the breed?
How many Pets in the home (this NEEDS to include cats & small animals)?
Ages, Breeds?
Are al lthe animals in the home vaccinatied and altered?
If no, why not?
Have you ever put an animal to sleep and why?
Are you willing to adopt a dog with any of the following issues(please check all that apply)?
Special medical needs
Needs socialization with people
Needs socialization with other animals
Has been formerly abused
Would benefit from obedience training
Basset's have many individual different traits. Please rate the importance of the traits you are looking for. 1 is very important 2 is somewhat important 3 doesn’t matter 4-less desirable 5- can't have
Good with Children
Good with Other dogs
Good with Cats
Crate Trained
House trained
Energetic/Loves to Play
Laid Back
Mixed Breed (Basset Mix)
If you rated any of the above a 1 or 5 please explain why?
Please explain what you do NOT want in a dog?
Time is needed for any dog to adjust to your home and schedule. Please explain how much time you feel is appropriate for a dog to adjust?
