DISCLAIMER - There are no guarantees made, expressed or implied, that any person requesting completing an application to adopt a dog through Lhasa Happy Homes Rescue, Inc. (LHH), or posted on LHH's Website,Petfinder and/or 1800SaveAPet will automatically be approved. All adoptions are subject to acceptance based on a review process that includes, but is not limited to reference check(s), in-depth interview and home visit. The decision to place any dog(s) in an adoptive home is determined by the review of such information, and adoption applications may be denied for any reason. LHH reserves the right to refuse to adopt to anyone without disclosing the reason(s) and to make decisions regarding the final disposition of any rescued dog in its care, whether in, or being placed in, a foster, adoptive home or other facility, confidential. Additionally, LHH reserves the right to post dogs on its website and/or Petfinder or 1800SaveAPet that under the auspices of other rescue group and LHH may have no jurisdiction over how these dogs are placed.
Finally, as a general rule, LHH does not adopt the Lhasa Apso breed to families with children under 8 yrs old. In some cases, we will adopt an owner surrendered dog or a dog whose background we are familiar with to a child 5yrs old +. **LHASA HAPPY HOMES DOES NOT SHIP DOGS OUT OF STATE UNDER ANY CIRCUMSTANCES and only in special cases will adopt out of state. In those rare but approved instances, primary adopter would be required to be present at LHH adoption event to receive dog.
RESCUE
ADOPTION APPLICATION
This questionnaire has been designed to aid us in determining if potential adoption homes are prepared to assume the type of responsible ownership we endeavor to assure for our rescued animals. Our goal is to be thorough; not invasive. Please answer all questions honestly and feel free to add your own comments. Please keep in mind that providing false information will result in the nullification of this application. PLEASE ANSWER ALL QUESTIONS. Thank you.
IF
A QUESTION DOES NOT APPLY PLEASE WRITE N/A, AS ALL FIELDS MUST BE FILLED.
ABOUT YOU (Person
applying must be 21 yrs of age and the primary individual responsible for
this animal)
Name:
Phone (Work):
Ext.:
Email:
Phone (Home):
Phone (Cell):
Best Time to Call:
Which Number:
Applicant's age:
Street Address:
City/State/Zip
Number of adults in
household:
Name of spouse/significant
other/roommate:
Spouse's Age:
Relationship to
you:
*Explain:
Your Occupation:
Spouses Occupation:
If this relationship
were to change, with whom would the dog(s) remain?:
Who will be primarily responsible
for the dog(s) care?
Do you have children?
Yes
No
Do they live with you?
Yes
No
Have they been around dog(s)?
Yes
No
List their ages:
If you do not have children now, are you planning a family in the future?
Yes No
If yes,
when?
If you
have children, are you planning to have more children in the future?
Yes No
If yes,
when?
What are your reasons for adopting
a dog(s)?
*Gift or Other/Explain:
Would you consider a dog with :
Special Needs
Yes
No
Behavior issues
Yes
No
Abused
Yes
No
Senior
Yes
No
Blind/Deaf
Yes
No
What are the qualities you are
looking for in a dog(s)?
Are you familiar with the characteristics/temperament of this breed?
Yes No
If yes, how so?
Does anyone in the household smoke?
Yes
No
Are you prepared to pay $40+ every 4-6 wks to groom your
dog(s)?
Yes No
In your
selection, what is your preference?
Breed:
Sex:
Age range:
Color:
My ideal pet:
What concerns, if any, do you have
about adopting?
HOME INFORMATION
I consent to a
home check in the event my application is approved.
Yes
No
Type of Dwelling:
Rent Own
Pets Allowed? Yes No
Years at Residence:
Do you have a Landlord/HOA? Yes
No
If you have one, may we contact your Landlord/HOA?
Yes
No
Don't have one
If no, please explain:
Landlord/Owner/HOA (Name, Phone #)
Where will the dog(s) stay during
the day:
Other, explain:
If the
dog is indoors only, what access does he/she have to outside?
How many hours a day will the dog(s) be left outside?
What outside space is available
for the dog(s)?
If fenced yard, what type?
*Other:
Height:
Do you have a grassy area?Yes
No
Do you have a pool?Yes
No
Is it fenced?Yes No
Other access areas
for dog:
*Other:
Will the dog(s) be tied up? Yes
No
Where will the dog sleep:
*Other/Explain:
Any areas where the dog(s) will not
be allowed?
Are you planning a move in the next six months?
Yes
No
Please explain:
If you ever had to move, would your dog(s) move with you?
Yes
No
Unknown
PAST/PRESENT PET HISTORY
Have you had a dog(s) in the past 10 years?
Yes
No
When? (Please
explain)
Do you now own a
dog(s)?Yes
No
Number of dog(s) in household:
Other animals in home:*
*If so, where are they housed?
History of dog guardianship/ownership (please
list each dog separately, list most recent dog first):
Breed
Sex
Altered?
Where did you
get the dog from?
Age of dog when you got it?
Still
Own Dog?
If no
longer own,
what happened to the dog?
Present age of
dog or age at death if applicable?
Please provide
detailed explanation if no longer have dog?
Have your dog(s)
been vaccinated?
Yes
No
Will you provide annual vaccinations?
Yes
No
Depends
If no or
depends, please explain:
Will you provide necessary medical care?
Yes
No
Depends
If no or
depends, please explain:
Veterinarian's name, phone number, address:
(current or most recent)
We must have this reference to process your application.
May Lhasa Happy Homes contact your
veterinarian?
Yes
No
If no, please explain:
How many hours per day will your
dog(s) be alone?
Explain:
Any provisions to let the dog(s)
out during the day?
How many
times will the dog(s) be walked each day?
How will your dog(s) spend the day?
Do you have a friend
or relative* who would care for the dog(s) if
you became incapable of caring for him/her for an extended period of time?Yes
No
Please provide name,
relationship to you
and their phone number:
Lhasa
Happy Homes reserves the right to approve individuals, with no bias, for
the protection of the dog(s).
Will your dog(s) be allowed on the
furniture?
Yes No
Will you become frustrated if your
dog(s) is not housebroken?
Yes
No
How do you plan on housebreaking
your dog(s)**?
Please
understand that even dogs that are housebroken will go through an adjustment
period.
What would make you consider giving up your
dog(s): (check all that apply)
Wouldn't give up for any reason
Accidents in the house
Pets don't get along
Moving
Divorce
New Baby
Dog grew to big
Allergies
Not obedient
Shedding
Chewing
Medical issues
Other (Please explain in notes at end)
What would you do with your dog(s)
if you could not keep for any reason(s) listed above?
*Explain
other:
If your dog(s) needed acute medical attention for an illness or emergency care, are you prepared to handle the expenses?
Yes
No
If your dog developed an illness
and required monthly medication, up to what amount would you be comfortable in spending?
(Please check one response)
*Other
amount, please explain:
Would you be
willing to adopt a dog that required monthly medication that costs under $50 a month?
Yes
No
If you currently have a dog, what
brand of food are you feeding him/her?
If a higher
quality food was recommended but is more expensive, would you be willing to
change foods?
Yes
No
If no,
please explain:
Have you ever trained a dog in
obedience?
Yes
No
Would you agree to take this dog(s)
to obedience school?
Yes
No
If the dog(s) becomes destructive,
what would you do?
When your dog(s) disobeys,
how do you reprimand?
Would you ever use a newspaper or object to
reprimand your dog(s) to stop bad behavior?
What would you
do if your dog starting snapping or bit at you or a family member?
*Other:
Will you be able to live with fur
on your furniture, stains on your rugs, a warm body on your bed, who may
be destructive at times?
Yes
No
What would happen to this
dog(s) if family situation changed (divorce, relocation, death)? Please answer this question in detail.
Have you ever given away/sold or released an animal to a shelter or rescue group?
Yes
No
If yes, why?
Have you ever been denied adoption by a shelter or other rescue or humane group?
Yes
No
If so by whom?
Do you travel a lot?
Yes No
Where will your dog(s) stay when you are
traveling or on vacation?
*Explain:
How did you hear about this group?
Please let us know who referred you so that we can thank them!
Please briefly describe your lifestyle:
(active, social, homebodies, etc.)
How is your general health
(health issues)?
Adopters over the age of 70 are required to have a co-adopter in case of accident or death. If this applies to you, who would be your co adopter: (name, address, phone number
and relationship to adopter)
Please give three additional references. These may be friends, co-workers and relatives. Please give name, relationship to you, email address and phone number.
Additional pertinent information:
Additional
pets information:
ADOPTIONS REQUIRE A HOME CHECK
and/or delivery of the dog(s). This does not include any special transport
or shipping where applicable.
PLEASE MAKE A COPY OF THE
COMPLETED APPLICATION AND BRING IT WITH YOU TO ADOPTIONS.
FOR BEST PRINT RESULTS, PLEASE SET PAGE ORIENTATION TO LANDSCAPE UNDER PRINTER PROPERTIES.
PLEASE MAKE SURE YOU HAVE
ANSWERED ALL THE QUESTIONS TO THE BEST OF YOUR ABILITY,
AS THIS WILL ONLY HELP US
IN DETERMINING THE RIGHT FIT FOR YOU.
THANK YOU FOR TAKING THE TIME TO COMPLETE
THIS APPLICATION. OUR GOAL IS NOT TO BE INVASIVE BUT TO MATCH THE BEST
POSSIBLE HOME FOR EACH ANIMAL.
