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ANIMAL RESCUE
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Adoption Application
First, Last name
*
Phone Number
*
Email
*
Street Address
*
City
*
State
*
Name of the animal you are interested in
*
Your age
*
Job Title
*
Employer
*
Work Phone Number
*
Non-family personal reference name
*
Non-family personal reference's number
*
What made you decide you wanted to adopt from Herding Home Rescue?
*
What made you interested in the particular animal you’re applying for?
*
What is your past experience with the breed you are applying for?
*
Describe both positive and negative traits commonly associated with the breed you are applying for.
*
How many adults reside in the house? Please list their names and ages.
*
Are there any children under 18 in the house? If so, please list their name(s), age(s), and their experience around animals.
*
Who will be the primary caregiver?
*
What most accurately describes your residence?
*
House
Apartment
Townhome / Condo
Other
Do you rent or own?
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Rent
Own
If you rent, are there any breed, size, weight, or number of pet restrictions on your lease?
*
If you are a renter, please list your landlord’s phone number and the name of your rental property.
*
Do you have a fully fenced yard with no holes or gaps? If so, please describe your fence height and material.
*
Do you have any of the following: swimming pool, cats, small animals (ie, rabbits), birds/chickens?
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Swimming Pool
Small Animals
Birds / Chickens
Livestock
Not Applicable
Other
Do you, or anyone in your home, have allergies to dogs, or asthma?
*
Yes
No
Have you fostered or adopted from an animal welfare group before? If so, what group?
*
Have you ever given up, rehomed, or otherwise surrendered a pet? If so, what were the circumstances?
*
Please provide the name and phone number of your current and, if applicable, previous veterinarian or clinic (even if your pet is deceased)
*
List the name, age, breed, and gender of the animals you currently own.
*
How many of these pets are spayed/neutered?
*
Where are these animals now?
*
If you've never had pet, and thus no vet reference, please give the name and phone number of one ADDITIONAL personal reference.
*
What's your activity level?
*
What type of personality do you want your dog to have? (i.e. calm, energetic, protective, couch-potato) Please be as descriptive as possible.
*
Have you ever house-broken a dog or puppy before?
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Yes
No
Other
If the dog were to have an “accident” in your home, what correction do you plan to use?
*
How many hours a day is the dog expected to be home alone?
*
Where will the dog be allowed during the day when you are home? Where will they be kept when you are away or unable to supervise?
*
Where will the dog sleep at night?
*
Are you willing to work through your dog’s issues, if any?
*
Are you aware a new environment can be stressful for a dog, and they may express uncharacteristic behaviors? It takes dogs 3 months to fully settle in a new home.
*
Yes
No
I'm not sure
All of our adoptables are up to date on vaccines and examined by a vet; however, emergencies happen. Are you financially prepared to cover any medical emergencies the dog may have, and to continue any medical care if they’re on a treatment plan?
*
Yes
No
Maybe
Are you aware it takes large breed dogs 2 years to mature, more so for working breeds?
*
Yes
No
Do you have a brand of food in mind? If not, we can recommend some.
*
Do you plan on attending training classes with your new dog? If you need training references, we can provide a list of resources.
*
Yes
No
Maybe
Other
Do you agree for Herding Home Animal Rescue and it’s associates to contact your veterinarian(s) and personal references?
*
Yes
No
Other
Do you agree to return the animal to the rescue if there is a need to rehome the animal, for whatever reason?
*
Intact animals are adopted out under the condition they are sterilized when age appropriate for their size or breed. If the pet you’re interested in is intact, do you agree to sign a spay/neuter contract, agreeing to sterilize the animal by the date?
*
Do you agree to keep all pets in the home up to date on vaccines, current microchip, and on flea, tick, and heartworm preventative, as well as an exam with a vet at least once a year?
*
Yes
No
Do you agree to let us occasionally check in post adoption to make sure they are adjusting well, and up to date on vetting?
*
Yes
No
Maybe
Other
Are all members of the household in agreement with the adoption? *Do not submit this application unless everyone is confirmed to be 100% on board*
*
Yes
No
Other
Any additional notes?
Electronic Signature
*
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