Pet Orphans

 

Apply to Small Dog Rescue & Humane Society

The first part of our adoption process is a completed application. If approved to adopt a dog from Small Dog Rescue & Humane Society (hereinafter referred to as "SDR&HS"), a $250 adoption fee is required. Please fill in the following information and click on the submit button at the bottom of the page if you are interested in adopting a pet from SDR&HS. Some situations (including, but not limited to, military deployment, employment that may involve an overseas transfer, major medical health considerations and senior citizenship) may require a Co-Applicant. Please note that SDR&HS does NOT adopt outside of Metro Atlanta. It may take up to 3 days to get a response from SDR&HS regarding this application. Most initial responses are via e-mail, please be sure your e-mail address is accurate below. Please check your e-mail for a reply from SDR&HS.

SDR&HS reserves the right to refuse any applicant. Applicants must be 21 years of age or older.

SECTION I - PERSONAL INFORMATION
Applicant:
First Name: Last Name: Age:Occupation:
Co-applicant (Spouse or Significant Other):
First Name: Last Name: Age: Occupation:
Street address:
Subdivision:
City: County: State: ZIP:
Home Phone: Work Phone: Cell Phone:
E-mail (required field):

What is the name of the dog/breed you are interested in?

List any general questions you would like to ask about this particular dog:

Are you willing to allow a representative from SDR&HS to visit your home by appointment? Yes No
Please check any of the following reasons for adopting this dog:   family pet   child's pet   watchdog   companion   hunting dog   guard dog for business   companion for other pet   gift   other - please specify:
Please indicate where you live: apartment house condo/townhouse trailer/mobilehome
Do you... rent? own?
If you rent, do you have the landlord's permission to own a dog? Yes No
      What is the apartment complex name?
      What is the landlord's phone number?
      How much is the pet deposit? $
How many times have you moved in the past 5 years? times
If you move, will your pet go with you? Yes No
Would you ever consider moving somewhere that doesn't allow your pets? Yes No
Do you have a fully fenced yard with no fence gaps? Yes No
If yes, how high and what kind (i.e., privacy, chain link, split rail, invisible, etc.)?

If no, would you consider fencing all or part of it as a condition of adopting a dog? Yes No
Do you have a doggie door? Yes No
If no, and it would work better, would you consider installing a doggie door? Yes No
Do you have a pool? Yes No

Number of adults in household?
Relationship(s):   spouse   roommate(s)   life partner   other - please specify:
Does anyone in the household smoke? Yes No 
If yes, please elaborate:
Do any family members have allergies? Yes No
If yes, please elaborate:
Will this dog be a surprise for any family members? Yes No
If yes, for whom?
Do any children live in the house or visit frequently? Yes No
If so, what are their gender/ages?
Do you foresee any major changes in your life in the next 15 years (average lifespan of a dog) such as marriage, childbirth, health problems due to age, going away to college? Yes No
If yes, please explain:
Do you or anyone in your household currently have any serious health problems? Yes No
If yes, please describe:
Can you provide a permanent home for this dog for 10-15 years? Yes No

SECTION II - CURRENT AND PRIOR PET HISTORY

Number, type, name and age of pets currently in household?
How many pets have you owned in the past as an adult?
If any, please describe what happened to each of them (put to sleep, run over, died of old age, sold, given away, ran away, etc.) and provide the name, breed and how long you owned each pet.
Do any of your current or did any of your past pets you owned as an adult live primarily outdoors? Yes No
If yes, please describe pet:
Were all previous pets spayed/neutered? Yes No
Are all current pets spayed/neutered? Yes No

Do you know what heartworm disease is and how to prevent it? Yes No
Is your current dog or was your previous dog on heartworm prevention medication? Yes No
If yes, how often do/did you give the heartworm medication? What brand do/did you use?
How do you plan to prevent fleas and ticks?
What is your current or most recent veterinarian's name?
And phone number?
What do you expect annual pet care (vet care, medication, heartworm preventative, etc.) to cost yearly?   $
Who will be responsible for the daily care and training of your new dog?
How many hours will the dog be home alone on a typical day?
Where does your current/previous pet stay when home alone during the day? outside in fenced yard outside in dog pen outside on chain or tie-out inside in basement in the garage inside free run of house inside in one room of house inside in crate  other, please describe:
Where will your new pet stay when home alone during the day? outside in fenced yard outside in dog pen outside on chain or tie-out inside in basement in the garage inside free run of house inside in one room of house inside in crate other, please describe:
Where do/did current or previous pets sleep at night? dog house in fenced area dog house in dog pen dog house near tie-out inside in basement in the garage inside free run of house inside in one room of house inside in crate in my bed other, please describe:
Where will new pet sleep at night? dog house in fenced area dog house in dog pen dog house near tie-out inside in basement in the garage inside free run of house inside in one room of house inside in crate in my bed other, please describe:
What percentage of time will the dog spend inside the house? %
Will your new pet be allowed on the furniture? Yes No  Certain pieces
Have you ever had a serious behavior problem with a previous dog? Yes No
If yes, please describe the behavior and measures you took to correct it:
Are you willing to go to obedience training with your dog if necessary? Yes No
Have you always kept an ID tag (other than a rabies tag) bearing your phone number on your pets? Yes No
Are you willing to keep a collar and ID tag on all of your pets including a new dog at all times? Yes No
Have you ever given a dog up or had a dog for a brief period of time and it didn't work?
Yes No  If yes, please explain the circumstances and what happened to it:
SECTION III - MISCELLANEOUS

Under what circumstances do you think it is OK to leave a dog outside alone and unsupervised in an unfenced area?   in a quiet subdivision   on a lot of acreage   in a rural area   when I know they are trained to come back   none

Under what circumstances do you think it is OK to leave a dog off-leash with supervision in an unfenced area?   in a quiet subdivision   on a lot of acreage   in a rural area   when I know they are trained to come back   none

What circumstances, in your mind, justify giving up a dog?   moving   new baby   not getting along with other pets   divorce   getting out of fence   behavioral problems   children lost interest   if it gets too big   too time consuming   shedding   allergies   housebreaking problems   medical problems   aggressive behavior   other - please explain:

Have you previously applied for a dog with either this rescue group or another rescue group? Yes No
If so, how long ago? Did you adopt? Yes No  Please explain:
If you are unable to keep your dog for any reason at any time will you return the dog to us? Yes No  If no, please explain:
If you date or marry someone who does not like or want your pets, what would you do?
Suppose your pet develops a medical problem that becomes expensive (i.e., $500 surgery for kidney stones or $20 monthly for eye ointment) but has a good quality of life. Do you:Find another home for him Pay whatever it takes? Have it put to sleep? Give the pet to a rescue group or the Humane Society? Depends on how much I like the dog other - please explain:
At SDR, our dogs are examined by vets and we convey to adopters everything that is known about the dog's health and physical condition up until, and including, the time of an adoption. Still, as living creatures, a dog that appears healthy in every way on one day, may begin to show signs of an illness or condition that later proves to be terminal or life threatening, the next day. If that should happen to you, with a dog you adopt from SDR, at what point would you return the dog to us? Within the first week after adoption?   Within the first month?   Within the first year?   At no point?  Please elaborate:
If your pet develops a frequent urination problem at the age of 12 and can't hold it when left alone, what would you do?   Have him put to sleep since he is older   Babygate him in where flooring is not carpeted   Give him to a rescue group or shelter   Put in a doggie door  Bellyband or diaper other - please explain:
If you are considering a long-haired breed, how often would the dog be groomed?
Would he get haircuts? Yes No   Would you do it yourself? Yes No
Have a groomer do it? Yes No 
How much would you expect it to cost on a per time basis? $
What type of food do you plan to feed?   something from the grocery store   premium food from a pet supply store  
Brand name:
Has a dog or puppy died on your premises in the last 6 months of distemper, parvo or other causes? Yes No
How did you hear about Small Dog Rescue and Humane Society? website newspaper   word of mouth radio at an adoption day other - please specify:
Please list the names, addresses and phone numbers of 2 personal, non-related and non-significant other references:
 
By signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of the rescue dog and possible removal of said dog from my home.
Signed: