Basset Buddies Rescue, Inc. Adoption Application

A successful adoption depends on both the selection of the right Basset for your household and the understanding of his/her care-taking needs. So that we may assist you in this selection, please answer the following questions as completely as possible. Thank You.

Contact Information

First Name
Last Name
Street Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Email
Referred By
Best time to call
When would you like to adopt? Name of dog you are interested in?

Household Information

Do you: Own Rent I live in a: House Townhouse Condo Apartment Trailer
If you rent, can you obtain written permission from the landlord to keep a dog there? Yes No
If you rent, please list your landlord's name and phone number:
Do you have a fenced area or yard? Yes No
If yes, what type of fence (chain link, wood, etc.) and approximate area enclosed:
If no fence, do you agree to keep the dog on a leash at all times when outside? Yes No
If no fence, what arrangements do you have for the dog's exercise and toilet duties?
Number of adults in household: Number of children in the household:

Age and gender of children:
Child 1
Age:
Male Female 		Child 2
Age:
Male Female 		Child 3
Age:
Male Female 		Child 4
Age:
Male Female
Which family member will have major responsibility of caring for the basset?
Is anyone in your household home during the day? Yes No
At Night? Yes No
On average, how much time will the dog spend alone per day?
Is anyone in your household allergic to dogs? Yes No Don't Know

Dogs and You

I am interested in a dog between the ages of and
I prefer a: Male Female Either Color Preference: Tri-Color Red & White Any
Have you ever owned a dog before? Yes No Have you ever owned a basset before? Yes No
Type of Dog: Have you ever owned a rescue dog before? Yes No

I understand that the basset hound: (please check yes if you understand)
Will need an annual heartworm test and preventative. Yes
Will need an annual checkup and vaccinations Yes
Will need periodic grooming, ear cleaning, and nail trims Yes
Will need plenty of exercise Yes
Will need approximately 4 - 6 weeks to adjust to my home Yes
Will shed year-round Yes
Is a scent hound and therefore must
NEVER BE OFF LEASH IN AN UNSECURE AREA		 Yes
The average cost in the first year to "outfit" your dog
(crate, dog bed, bowls, toys, food and vet care) could exceed $500? Yes
Why do you want to own a basset?
Are you willing to housetrain the basset if necessary? Yes No
Are you willing to work with the Basset Buddies Rescue, Inc. trainer if problems arise? Yes No
Are you willing to take the basset to obedience classes if necessary? Yes No
Where will the basset be kept during the day? at Night?
Where will the basset be kept when no one is home?
Are you willing to use a crate to confine the basset when you cannot supervise him/her? Yes No
Have you ever crate trained a dog? Yes No Do you have an available crate for your dog? Yes No
Are you willing to allow someone from Basset Buddies Rescue, Inc. visit your home prior to adoption? Yes No

Other Pets

Do you presently have other pets? Yes (Please complete table below) No

Breed

Age

Sex

Fixed

In Family since:

Temperment

Behavior with other Dogs?
Male
Female		 Yes
No		 Dominant
Submissive
Male
Female		 Yes
No		 Dominant
Submissive
Male
Female		 Yes
No		 Dominant
Submissive
Male
Female		 Yes
No		 Dominant
Submissive
Do you have a regular veterinarian? Yes (Please complete table below) No

Name of Veterinarian

Clinic

Address

Phone
What pet(s) name(s) and last name are on your veterinary records?
If you don't have a regular veterinarian, please give name and phone number of two references:

Name:

Phone Number:

Relationship:
Have you ever given up a pet before? Yes No
If yes, what type and why?

I HAVE READ, UNDERSTAND, AND AGREE TO COMPLY WITH
THE BASSET BUDDIES RESCUE, INC. ADOPTION POLICY: YES NO

ALL OF THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE. I UNDERSTAND THAT FALSIFYING ANSWERS ON THIS APPLICATION, OR AT ANY OTHER TIME DURING THE ADOPTION PROCESS, DISQUALIFIES ME FROM ADOPTING FROM BASSET BUDDIES INC. (BBR). I AM AWARE THAT SUBMITTING THIS APPLICATION DOES NOT GUARANTEE THAT I WILL RECEIVE APPROVAL TO ADOPT A DOG FROM BBR. BY SUBMITTING THIS APPLICATION, I HEREBY AUTHORIZE BBR TO ACCESS MY VETERINARY RECORDS.