Hart Animal Rescue - Dog Application

Dog/Puppy Application

Your Name(*)

Please let us know your name.

Adress(*)

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phone(*)

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Your Email(*)

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Do you rent or own?(*)

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If You Rent please answer the following

If renting, are pets allowed?

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What is your landlords name?

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What is your landlords phone number?

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Number in household?

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Number of children and ages (in household and visiting)?

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Is anyone in household allergic to dogs/puppies?

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Do you want to be on our e-mail distribution?

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About the Pet You Want to Adopt

Why do you want to adopt?(*)

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Name and Number of dogs you are interested in adopting?(*)

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Type of Dog/Puppy(s) you are interested in (if applicable)?:

Age Range

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Size

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Gender

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Activity Level

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Where will the dog be when no one is home?

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While on vacation

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Where will the dogbe allowed in your home?

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On a typical day, how many hours will the dog be home alone?

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Are you financially able to provide ongoing medical care?

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Will you be letting the dog go outside?

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Where will the dog sleep?

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Pet Ownership - Please list the following for all pets owned if this does not apply to you please mark with NA

Name, Type/Breed, Age, Sex(*)

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Have your pets been Spayed/Neutered?(*)

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Are your pets up to date on vaccinations?(*)

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Number of years owned?

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Do they still live with you?

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If not, why?

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Have you ever owned a dog/puppy?

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Does anyone in your household have an allergy to dogs?

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Have you ever relinquished a pet?

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If yes, why?

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Have you considered the possible damage dogs can do (scratching, biting, shedding)? How will you handle these possible damages?

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If you move, will you take the dog with you?

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Do you agree to a home visit and follow up contacts?

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Do you agree to care for this dog for its lifetime (possibly 15+ years)?

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Do you agree NOT to dispose of this dog in any way?

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Do you agree NOT to Declaw under penalty of litigation and/or removal of cat by HART?

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Do you have a vet?

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Permission to contact vet?

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Vet's Name

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Vet's Phone Number

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We require 2 references:

Reference #1 name(*)

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Reference #1 Street address(*)

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Reference #1 phone number(*)

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Reference #2 name(*)

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Reference #2 Street address(*)

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Reference #2 phone number(*)

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Signatures

I verify that all information listed above is accurate. I understand that HART can deny an application for any reason.(*)

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Signature of Applicant(*)

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Date of Application(*)

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Please note that HART does not have a shelter or other physical location. All animals in our care are located either in a foster home of one of our volunteers or temporarily at the Adoption Center of one of the PetSmart stores that we coordinate with. Consequently, there may be some delay between submitting your Application and the time that you receive a response from one of our volunteers and can meet the animal of interest, but we will contact you as soon as we can, typically within 24-48 hours.

Subject(*)

Please write a subject for your message.

Dog Application

Dog/Puppy Application

Information

QUICK LINKS

Company

Homeless Animal Rescue Team of Cincinnati