Washington Basset Rescue

Adoption Application

This may seem like an excessively detailed, even invasive, questionnaire, but please keep in mind that the more information we have about you, your household and your expectations of your rescued dog, the easier it will be to make a successful match.  Finding the perfect match between adopter and dog is our most important goal.  Washington Basset Rescue reserves the right to refuse adoption to anyone.  No animals will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application. 

Are you inquiring about a specific dog? ______ If Yes, Name of Dog: _____________________

 Date:   ___________________ Name_________________________________________________

 Birthday:  _____________ Address: __________________________________________________

City:  ________________________State:  _________________________      Zip:  ______________

 Home Phone:_____________________________ Work Phone:____________________________         

Cell Phone: ____________________________ Email Address: _____________________________

 How many adults in the household? ________

Please list their names, ages and occupations: ________________________________________

_________________________________________________________________________________

 How many children in the household? _________

Please list their names and ages:  ___________________________________________________

_________________________________________________________________________________

 If no children in the home, do grandchildren, nieces/nephews or other kids ever visit? __

 Who will be the primary caregiver for the new dog?  ________________________________

 Does this person work away from the home?  ______________________________________

If so what are you plans for letting the dog out to potty during the day?  ________________

_____________________________________________________________________________

 How many hours per day will the dog be left alone?  ________________________________  

If you are out of WA state, have you checked with your state's Basset Rescue?___________ 
If not, why ____________________________________________________________

If you are out of the adoption area, what are your plans for transporting this basset?
_____________________________________________________________________________

 How long at current address?  ___________________________________________________

 Is it a house, condo, apartment or other (please specify)? ___________________________

Do you own or rent?  __________  If you rent, please provide the name and phone number
of the property owner:  ___________________________________________________________

 Do you have a securely fenced yard? __________________________

If so, what type of fence is it (wood, chain link, block wall, etc.)?  ______________________

How high is it?  ______________________________

 Is there a doggie door leading to the yard?  _______________________________________

 If you do not have a fenced yard, where and how often do you plan to take your dog to potty?

_______________________________________________________________________________

 Will the dog be on a leash? ________________________

Under what circumstances would you allow your dog to be off-leash?  __________________

_______________________________________________________________________________

 Are there any areas of the house where the dog will not be allowed?  _________________

_______________________________________________________________________________

If so, how will you keep the dog out of them?  _______________________________________
_______________________________________________________________________________

 Will the dog be allowed on the furniture?  _________________________________________

If not, how will you keep it off the furniture?  ________________________________________

Will the dog be given the run of the house when no one is at home? ___________________

Where will the dog sleep?  _______________________________________________________

Have you ever trained a dog to respond to simple commands?  _______________________

If so, how would you describe the method you used?  ________________________________

How will you discipline your new dog for undesirable behavior? _______________________

If your new dog is not housetrained, how will you housetrain it? _________________________

Are you aware that even housetrained dogs need a period of adjustment in a new home? ___

What will you do if the dog has “accidents” in the house?_______________________________

How many dogs have you owned?  ___________________________________________________

How long did you have your last dog?  _________________ How long ago?  ________________

Did you have the dog until it died?   ____________  If so, at what age did it die? ____________

If not, what happened to it?  ________________________________________________________

Was it spayed/neutered?  __________________________________________________________

Do you currently have a dog (s)? __________

         If so, please list their breed, age, sex and whether they are spayed/neutered: _________

_______________________________________________________________________________

 Where have your previous or current dogs mostly lived, indoors or outdoors?  ____________

 Do you have any other pets or farm animals?        If so, please list species:  _______________

_______________________________________________________________________________

 If you have a cat(s), describe how you hope your new dog will interact with it: _____________

_______________________________________________________________________________

 How do you intend to exercise your new dog?   _________________________________________

 Do you have what you consider an active lifestyle or are you more the couch potato type? _______________________________________________________________________________

 Do you travel a lot?  _______________________________________________________________

 When you go out of town,
what arrangements will you make for the care of your rescued dog? ______________________

__________________________________________________________________________________

 If anything were to happen to you, what do you anticipate would happen to your dog?  ____________

_________________________________________________________________________________

 Why do you want a dog (or another dog) at this time?___________________________________  _________________________________________________________________________________

 Why do you want this dog in particular?  ________________________________________________

 Have you ever had a rescued dog before? ______________________________________________

 Why do you want a rescued dog?  ____________________________________________________

 Have you ever had a basset before? __________________________________________________

If not, what are you interested in a basset?  _____________________________________________

 What characteristics do you especially want in your new dog? ______________________________

 What characteristics do you not want in your new dog?  ___________________________________

 What will you do if your new dog has some unwanted characteristics? ________________________

 What is the age range of the dog you hope to adopt?  _____________________________________

 What sex and why?  __________________________________________________________________

 How important to you is it that the dog already be housetrained?  ____________________________

 Are you willing to adopt a special needs dog (requires medication, deaf or blind, etc.)?  _________

 What will you do if your rescued dog barks a lot?  _________________________________________

_______________________________________________________________________________

Please provide the name and phone number of your current or previous veterinarian: ________________________________________________________________________________

Please provide the names and phone numbers of two personal references,
not including family members:  ________________________________________________________________________________

________________________________________________________________________________

Do you agree to have a representative of Washington Basset Rescue visit your home prior to adoption? __________________________________________________  

Do you agree to pay an adoption fee, depending on the dog’s age, health and possible special needs?  ____________________________________________________  

If you move, what are your plans for the dog? ____________________________________________________________________________________

I agree to provide adequate food, shelter, water, medical treatment and humane treatment at all times.

I understand that Washington Basset Rescue reserves the right to investigate the care, treatment and environment of adopted animals at any time, and has the right to immediately remove any animal adopted through them, if they feel it is in the best interest of the animal.  Adoption fees will not be refunded after a period of 2 weeks.

WABR will not be held liable for any personal liabilities or damage to property or financial indebtedness incurred for the care of the adopted animal after adoption.

__________________________________     ____________________   

Applicant Signature                                                   Date

Thank you for completing this application and thank you for wanting to give a forever home to one of our rescued animals!

SEND TO: 

rescue@wabr.net

 Pat Benstine, 7220 N. Haven, Spokane , WA 99218