THR Pre-Adopt Dog

TenderHeart Rescue
Dog Pre-Adoption Questionnaire

A dog may live for 15 years or more. We hope you are prepared to make a commitment to this pet for its lifetime. Our primary focus of concern during the adoption process is the future welfare of the animals we have rescued. In that regard, we ask that you answer the following questions. Please do not consider this an invasion of your privacy. We want this to be a wonderful experience for you and your family, but our responsibility is the health, welfare, and happiness of the animals in our care.

** PLEASE NOTE: VETERINARIAN REFERENCE SHOWING DOG OWNERSHIP HISTORY REQUIRED TO ADOPT OUR DOGS. **

YOU MUST FILL OUT EVERY QUESTION
INCOMPLETE QUESTIONNAIRES WILL NOT BE CONSIDERED

Adopter's Name: *

Pet(s) Interested In: *

Street Address: *

City: *

State: *

Zip: *

Email Address: *

Phone Numbers: (h) *

Will the animal live at the address listed above? *

Yes

How long have you lived at this address? *

Do you: *

Own

Rent

Live with parents

Other Other

Landlord's Name & Phone Number if Renting:

Are you aware of the license, leash, and animal laws in your community? *

Yes

How many adults live in your household? *

Do they all want a pet? *

Yes

Will there be an adult home during the day? *

Yes

Part-time

Other Other

How many hours will the pet be home alone each day? *

Who will be the primary caregiver? *

How many children live in the household? *

Please list ages of children: *

Are you interested in adopting for: *

Yourself

Family

Someone else

Other Other

Do you or anyone in the family have allergies to animals? *

Yes

Other Other

Are you employed? *

Yes

Other Other

How long? *

Employed Where? *

Do you or your spouse have jobs that require relocation? *

Yes

Other Other

If yes, how often do you relocate?

What will you do with your new pet if you do relocate?

How do you plan to exercise your new pet? *

Who will primarily be responsible for training? *

List some problems associated with raising a puppy: *

Have you crate-trained a dog/puppy before? *

Yes

Do you plan to crate your new dog(s)? *

Yes

Other Other

It may take your new pet a month or longer to adjust to its new home. Are you prepared to allow this much time? *

Yes

Concerns? Concerns?

As a potential new pet owner, what behaviors are you not willing to tolerate from a pet? *

What will you do to correct the behaviors you have listed? *

Do you realize the costs associated with monthly heartworm and flea/tick preventative? *

Yes

What heartworm preventative do you use? *

What flea/tick preventative do you use? *

Is your front or back yard fully fenced? *

Yes

Other Other

If so, what type of fencing?

If you do not have a fenced yard, how will you provide for the safety of your new pet? *

Do you have acreage? *

Yes

If so, how much? If so, how much?

Can you provide a doghouse or sufficient shelter to adequately prevent the animal from the heat, cold, rain? Please explain: *

Where will your new pet live? *

Where will your new pet stay when no one is home? *

Where will your new pet sleep? *

How many hours will they spend alone? *

How will your animal be cared for when you leave town? *

Have you every adopted a pet from another humane society? Please explain. *

IF YOU HAVE NEVER OWNED A PET, PLEASE STOP HERE.

You MUST have an excellent vet/pet history to adopt from our rescue. This means we will call your vet for proof of proper care of your pet including: vaccines, spay/neuter, heartworm prevention and any other care needed for illness or injury.

*** VERY IMPORTANT *** YOU MUST ACCURATELY LIST YOUR VET(S) AND ALL CONTACT NUMBERS. ANY APPLICATION MISSING THIS INFO WILL NOT BE PROCESSED AND YOU WILL NOT BE CONTACTED.

Please make sure your vet records are under the name specified. We will not continue to go back and forth on your vet history. Please list the name and phone number of the vet clinic(s) that cared for your pets.

Clinic/Vet Name *

Phone Number *

Do we have your permission to contact your vet for a vet reference? If so, Please contact your vet and ask them to allow us to access your pet history. *

Yes

Other Other

Are all current pets spayed/neutered? *

Yes

Other Other

Were all previous pets spayed/neutered? *

Yes

Other Other

Please provide detailed information for each current pet (Name, sex [spayed/neutered], UTD on vaccines & HW prevention. *

Please give name & history of previously owned (no longer living in the home) pets and what happened to them *

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Did any of the previous pets contract and/or die of Parvo, Distemper, Heartworm disease, or any unknown disease in the past 12 months? *

Yes

Other Other

If the answer above was yes, did the pet(s) live indoors, outdoors, or both?

On average, how much do you spend yearly on their care (medical, vaccines, heartworm prevention, flea control, food, etc) for each of your pets? *

What type of pet food do you use today? *

Have you ever turned an animal in to a humane society, animal control (pound), or euthanized an animal? Please explain. *

Do you realize that if your pet is not provided with the appropriate attention and affection that he/she may experience loneliness, boredom, frustration, etc. This may translate into your pet's destructive behavior such as inappropriate chewing, barking, digging, aggression, etc? *

Yes

Do you mind if we visit you at your home before adoption? *

Yes

Other Other

Please list convenient days/times:

Are you financially able to provide veterinary care to your pet due to: illness, emergency, broken bones, etc? *

Yes

Other Other

Do you realize the charges incurred at the emergency vet? *

Yes

What are your expected costs for an emergency visit? Must enter a $$$ amount along with explaination *

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If your pet has a disease that requires long-term vet care, can you provide the care that is needed to maintain a quality life? *

Yes

Other

Please explain any condition for YOU or YOUR PET that would cause you to give up your pet or no longer care for your pet medically or financially? *

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Please add comments/additional info here: *

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BY SIGNING THIS APPLICATION YOU ARE STATING THAT YOU INTEND TO PROVIDE A TENDERHEART RESCUE BABY WITH THEIR FOREVER HOME REGARDLESS OF WHAT MAY HAPPEN IN THE FUTURE.

IF YOU CANNOT COMMIT TO THIS WITHOUT THE POSSIBILITY OF WHAT COULD HAPPEN, THEN PLEASE DO NOT TURN THIS APPLICATION IN FOR REVIEW.

Adopter's Signature: *

Date: *

Your signaure above guarantees that the information you have provided is accurate and truthful. It does not guarantee adoption of a dog from TenderHeart Rescue.