Adoption Application

Important - The first step in the process of adopting a pet from Heidi's Legacy Dog Rescue is to complete this application. The application provides important information.

Working with you, we will be able to determine if the adoption is in the pet's best interest, and the process ensures that you will find a pet well-suited to your lifestyle. We are all volunteers, please provide detailed information for all questions.

What is the name of the dog that are you interested in adopting? If you have no specific animal in mind, please tell us what kind of dog you want to adopt... your preferences with regard to breed, sex, age, color etc:

Email Address Listed in the Dog's Bio (must be formatted: name@example.com)

How did you hear about Heidi's Legacy?

Personal Information

Full Name

Address

City

State

ZIP

Driver License Number

Email

Primary Phone

Mobile (or alternate) Phone

Your Age

Age Requirement:
Heidi's Legacy requires all persons applying to adopt a pet to be at least 24 years old. Are you at least 24 years of age?

Employment

Employer & Position

Time Employed

Supervisor/Manager Name

Employer Phone

Information About Your Household

Please list all people and their ages who currently live in your household or visit often. (Please list relationship to you & their age. We don't need the children's names.)

Who will be the primary care giver for the newly adopted animal?

Does anyone in the household have any known allergies to animals?

If yes, please explain

Information About Your Home

Which of the following best describes your current residence? (Select one)

Length of time at this address

Do you own or rent?

If you are renting, have you checked with landlord to make sure dog you are interested in will comply with pet policy? If you adopt, please plan on providing us with a copy of the pet policy from your lease and providing the following information now:

Landlord's name and phone number

Does your residence have a (check all that apply)
 Yard Fence Dog Run Dog Door

If fenced please specify type and height of fence
Type of Fencing (Materials)

Fence Height

If you do not have a fence, please explain how you will address the dog's exercise and bathroom needs, etc.

Does your residence have a pool or hot tub?

If yes, is it fenced/covered so that pet CANNOT get to it?

Please provide details:

The Animal You Want to Adopt

Type of companion animal you are seeking

If other, please specify

Why are you interested in adopting? Please check all that apply.
 Companion for Self Companion for Family For Breeding Gift For Protection For Child Replace Previous Pet Companion for Other Pet Other
If other, please specify

Is this your first pet as an adult?

If no, please list pets you have had previously and the duration they were with you. What happened to these animals?

Your Current Animals

What animals currently live in your household? (Please include the following info for each pet:
Name of pet, type of pet, sex/age, How long owned? Kept where?)

How do you plan to introduce the new pet to the household?

Are you prepared for the expenses that are incurred annually for veterinary medical costs?

Are your current pets up to date on shots, heartworm preventative, veterinary care, etc?

If not, please specify which ones and why not.

Are all your current pets spayed or neutered?

If No, why not?

How will you handle the following potential situations?

Family allergy to pet

Pet medical expenses: (emergencies or diagnosed medical condition)

If you should move what will become of the pet?

If you are incapacitated and unable to care for your dog any longer, where will the dog go?

Are you prepared to spend several weeks or, perhaps months, waiting for your new pet to adjust to a new environment?

Your Veterinarian
Please call your vet now and give them your permission to speak to us. They need to note this in your file. Provide the following information so we can contact your current veterinarian.

Vet Name

Vet Address (full address please, including city and zip code.)

Vet Phone and name of person you just spoke with (Please include area code)

Date, pet name and reason for most recent vet visit.

Name of person that file is under at vet office.

We reserve the right to check your status with your vet and to inspect all homes and yards prior to approving any adoption. Is this okay?

Your Experience With Animals

Have you ever had any complaints about your pets?

If yes, please explain

Are your current pets friendly with other animals?

Have you ever had to give up a pet before? What were the circumstances? Where did the animal end up?

Do you plan on having your new pet enrolled in obedience training?

If yes, where?

Which of the following behaviors would present a problem for you or your family? Please explain how you will handle or correct each situation:

Your reaction if the newly adopted pet begins jumping on furniture/ counter tops/ table

Your reaction if the newly adopted pet begins scratching/ biting/ ripping furniture

Your reaction if the newly adopted pet begins chewing on plants/ garbage/ other

Your reaction if the newly adopted pet begins barking and/or howling

Your reaction if the newly adopted pet begins play biting

Your reaction if the newly adopted pet urinates/defecates inside the house

Your reaction if the newly adopted pet keeps you awake at night

Your reaction if the newly adopted pet sheds excessively

Your reaction if the newly adopted pet were to ruin an expensive article

Taking Care Of Your Newly Adopted Pet

What is the longest duration you will leave your pet unattended outside?

Where will your pet be kept:
At night. Be specific.

Day time. Be specific.

How many hours a day will there be someone at home with this pet?

How many hours a day will this pet be alone at home? (without human companionship)

What brand of food do you plan on feeding your new pet?

Please List 2 Personal References (Unrelated to You)

Reference 1 Name

Reference 1 Phone

Reference 2 Name

Reference 2 Phone

Have you applied to adopt from another rescue within the last year? Which organization?

Any other comments you'd like to add for consideration of your application to adopt?

Would you consider volunteering for our organization?

If yes, which of the following areas interest you?
 Temporary Foster Care Personal interviewing of adoption candidates Fundraising Home Visits Transporting Computer Assistance Telephone Calling Representing Us at an Adoption Event Other
If Other, please specify

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