Adoption Application

Contact Information

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Work Phone*
x

Cell Phone*

Alt Email*

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Which animal are you interested in adopting? DOG'S NAME:*

We know that the Application requires detailed information. This information is very important to us because we want both the dog and you to be happy together. Our goal is to make every adoption a good match. Accordingly, please be candid and think carefully when answering these questions; please answer each question. The decision to own a dog is a lifelong commitment of time, energy, and finances. We try very hard to find forever homes for our dogs. Because we care about our dogs, not all applications will be approved, or approved for the particular dog that you are interested in adopting. **Puppies that are too young to spay or neuter are made available ONLY on a foster-to-adopt basis, with adoption occuring once they are spayed/neutered by our veterinarian.** Thank you very much for taking the time to complete this Application -- we hope that we can help find the perfect dog for you. Please type "I Agree" in the field below to indicate your understanding of this policy.*

How long at this address?*

Occupation: *

What is the best time to reach you by phone? (PLEASE provide at least *two* phone numbers, if there is a typo a the number you provide we will not be able to reach you or leave a voicemail...)*

How many adults are in your family? Please list their full names, ages, and relationship to you:*

How many children are there in your family and what are their ages?*

What type of home do you live in?*

Please describe your household:*

Active	Noisy
Quiet	Average

If you rent, are you allowed to have a dog or the breed of dog that you intend to adopt?*

If you rent, please provide the landlord's or property manager's contact information. By providing this information, you are allowing Better Days to contact your landlord or property manager to obtain a copy of your lease. PLEASE INFORM YOUR LANDLORD OR PROPERTY MANAGER OF THIS CALL. (If you own your home, please simply type, "I/we own the home.") *

Does anyone in the family have a known allergy to dogs?*

Yes

Is everyone in your home in agreement with the decision to adopt a dog?*

Yes

Do you have time to provide adequate time, love, and attention to the dog you adopt?*

Yes

Do you have a fully-enclosed fenced yard?*

Do you have a swimming pool?*

Will your dog have continuous access to a doggie door?*

Yes

Please describe your reasons for wanting to adopt a dog.*

Please describe why you think you would be a good owner for a dog.*

How long are you willing to allow your new dog to adjust to his/her new home?*

If your dog gets lost, what would you do?*

If you have to move, what would you do with your pets?*

What characteristics of a dog are most important to you?

Assertive	Protective
Companion	Athletic
Active	Friendly
Good With Children	Playful
Couch Potato	Independent
Good With Other Dogs	Good With Cats
Other (describe below)

What other characteristics, if any, do you seek in a dog?*

Where is your dog going to be when you are at home?*

Where is your dog going to be when no one is home?*

I would consider surrendering my dog due to the following conditions:

I would consider surrendering my dog due to aggression towards friends, family, or strangers (please describe):*

I would consider surrendering my dog due to aggression towards other dogs (please describe in detail):*

Would you attempt to resolve behavior problems with training, prior to considering surrendering a dog?*

Yes

I would consider surrendering my dog due to the following conditions:

Veterinarian bills have become to high	The dog requires daily medical treatment
The dog requires a special diet	The dog has become disabled
Other (please detail below)

Please list pets that you presently own or that reside with you, specifying species, breed, age, gender, and how long owned:*

Are these dogs up to date on vaccinations?*

Yes

If any of your dogs are not up to date on vaccines, please state the reason. (If you do not currently have dogs, please simply type "N/A")

Are your dogs on heartworm preventives?*

Yes

Are these dogs spayed/neutered?*

Yes

If these dogs are NOT sterilized/altered, please explain reason (for each dog.) If they ARE all sterilized, please state "N/A".*

Have you ever surrendered a pet?*

Yes

If you have surrendered a dog, please state all your reasons for surrendering your dog.*

Have you ever had a pet euthanized?*

Yes

If you have had a pet euthanized, please state all your reasons for doing so. (If you have not euthanized but have owned dogs before, please let us know what happened to them.)*

Have you ever lost a dog due to an accident?*

Yes

If your pet was lost due to an accident, please explain the accident. (If not applicable, please type "N/A")*

Have you ever lost a dog because the dog escaped or ran away?*

Yes

If you have lost a dog because it escaped/ran away, please explain in detail what happened. (If this has never happened to you, please type "N/A")*

How do you discipline your dogs? Please explain why you think this form of discipline is appropriate.*

What type of dog food do you feed your dogs? Please specify type and brand name, and frequency of feeding. (If you don't currently own a dog, what type of food do you plan to feed once you have a dog?)*

What is your idea of an ideal dog and why?*

Desired Age:*

Desired Size:*

Desired Breed(s):*

Breed(s) you would not adopt:*

Desired Gender:*

I am willing to adopt:

Very outgoing or hyper dog	Very shy dog
Dog that needs regular medications	Dog that needs training
Dog that needs grooming	None of these

Where will the dog spend the day? (please describe)*

Where will the dog spend the night? (please describe)*

Number of hours (average) the dog will spend alone (without a human at home) per day:*

Who will have primary responsibility for this dog's care?*

Who will have financial responsibility for this dog?*

Do you agree to provide regular health care by a licensed veterinarian?*

Yes

Do you agree to keep the dog as an indoor dog?*

Yes

Do you agree to contact Better Days Rescue if you can no longer keep this dog for any reason? Our website: BetterDaysRescue.org Our email: info@betterdaysrescue.org Our phone: 480-757-9660*

Yes

Do you agree that you WILL NOT sell the dog, transfer the dog, gift the dog, or surrender the dog to any person, rescue, or shelter, without first contacting and reaching Better Days Rescue?*

Yes

Are you willing to let a representative of Better Days Rescue visit your home by appointment if requested?*

Yes

Do you intend to crate the dog?*

Yes

Are you financially able to provide quality medical care and quality food for your dog?*

Yes

Would you be interested in fostering a dog or dogs, for short or ongoing periods?*

Yes

Do you have a regular veterinarian?*

Yes

Please provide the name, clinic name, address, and telephone number of your veterinarian:*

How did you hear about this dog and Better Days Rescue?*

Please list name, address, and two telephone numbers of someone who is familiar with both you and your dogs. Please state their relationship to you (relative, neighbor, friend etc.) and how long you have known them.*

Please list a second person who is familiar with both you and your dogs. Please include name, address, two telephone numbers, their relationship to you, and how long you have known them.*

I assert that all of the information I have given is true and complete. I will provide the dog with quality food, plenty of fresh water, indoor shelter, affection, annual physical examinations and vaccinations under the supervision of a licensed veterinarian. I affirm that I have never been detained, cited, or arrested in connection with any matter involving animal cruelty or animal abuse. I understand that any misrepresentation may result in Better Days Rescue refusing adoption privileges to me. I authorize Better Days Rescue to contact all veterinarians on the application, as well as my landlord, if applicable. If my request for adoption is approved, and later Better Days Rescue discovers the above information is not true or correct, Better Days Rescue reserves the right to remove the adopted dog from my home. PLEASE TYPE YOUR FULL NAME AND THE DATE BELOW:*

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