Dog Adoption Application

Helping Hands Rescue (HHR) is thrilled you are considering adopting a rescue animal. Please understand that we are an advocate for the rescue animal and that the animal’s well-being is our #1 priority.

Keep in mind that completing an application is not a guarantee of adopting the animal. Our application process is designed to help us determine if a home matches a pet’s needs and assist in finding a pet that is most compatible with your lifestyle and expectations. **Helping Hands Rescue requires an applicant be 21 or older to adopt.**

What dog or puppy are you inquiring about?

What personality are you looking for in your new dog or puppy?

Adopter Information

Name(Required)

First Last

Primary Contact Phone(Required)

Adopter DOB - Must Be 21 to Adopt(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Are you employed?(Required)

Yes

Employers Name

Household Information

Name and Ages of All Adults in Home:(Required)

Number of Children in Home:(Required)

Age(s) of Children in Home:

If no children, do small children visit and how often?

Please describe your household:(Required)

Active

Noisy

Quiet

Average

Why are you looking to adopt a Dog or Puppy?

Companion For You/Spouse

Companion For Another Pet

Companion For Child/Children

Replace Lost/Deceased Dog

Need A Travel Companion

For Emotional Support

Looking for a Protector

As A Gift

It's Cute

Other

List other animals in the household; please indicate age and if they are spayed or neutered:(Required)

Do you:(Required)

Rent

Own

If you rent, does you rent agreement allow pets?(Required)

Yes

N/A for Homeowners

Landlord Name and Contact Information?(Required)

If own home, please put N/A in field

Dog Care Questions

Is everyone in your family in agreement with the decision to adopt this dog?(Required)

Yes

Are you prepared to care for this dog for its entire life (10-15 years)?(Required)

Yes

Who will be responsible for the care of the dog?(Required)

Do you have time to provide adequate love and attention to your new dog?(Required)

Yes

Will your dog be an indoor or outdoor dog?(Required)

Indoor

Outdoor

Both (wherever it wants to be)

How many hours a day will your dog be left alone?(Required)

Where will the dog be while at home alone?(Required)

Kenneled Indoors

Kenneled Outdoors

Left Free Roaming in the House

Outside in Fenced Yard

Chained Outdoors

Designated Area Indoors

Where will your dog sleep?(Required)

Are there any areas of the house where the dog will not be allowed? If yes, how will you keep the dog out of them?(Required)

If your dog prefers a crate will you provide one?(Required)

Yes

Do you have a securely fenced yard?(Required)

Yes

If yes, what type of fence is it (wood, chain link, block wall, etc.)? How high is it?(Required)

Is there a doggie door leading to the yard?

Yes

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

Under what circumstances would you allow your dog to be off-leash?(Required)

How important to you is it that the dog is already house-trained?(Required)

How will you house-train your dog if not already?(Required)

Have you ever trained a dog to respond to simple commands?(Required)

Yes

If so, how would you describe the method?

What characteristics do you especially want and not want in your dog?(Required)

What will you do if your new dog has some unwanted characteristics?(Required)

Describe how you would discipline your dog for unwanted behavior? (chewing, potty in house, excessive barking, etc.)(Required)

What behavior(s) are you unwilling to work with in your new dog?

Potty in House

Food Aggression

Herding Children

Social Anxiety

Too Active/Hyper

Excessive Barking

Separation Anxiety

Animal Aggression

Escape Artist/Runner

Over Protective

Shedding

Chewing

Jumps on People

Fence Jumper

Digging

Nipping/Biting

Other

Would you consider debarking your dog?

How many dogs have you owned?(Required)

How many years did you have your last dog? How long ago was that?(Required)

Did you have the dog until it died? If not, what happened to it?

Where have your previous pets lived? Indoors/outdoors?(Required)

Do you agree to spay/neuter this dog, if not already done?(Required)

Yes

If no, why?

What circumstance might justify giving up your dog?

Illness

Pregnant/New Baby

New Girl/Boyfriend/Spouse/Partner

Divorce/Breakup

Moving

Allergies

Shedding

Not getting along with other animals

Lost Interest

Other

I would not give up my dog for anything

Who will be responsible for the animal if you become unable to?(Required)

Please list name and phone number.

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

Please list name and phone number.

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

Yes

Vets name and phone number:(Required)

Please list name and phone number.

List any other information you feel would be important for Helping Hands to know:

By selecting the checkbox below I agree to:(Required)

Provide adequate food, shelter, water, medical and humane treatment at all times. I understand that Helping Hands 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 include initial set of vaccines, worming and parasite treatment, rabies vaccine, and spay/neuter. Adoption fees will not be refunded after a period of two weeks. I understand that if at any time I can no longer care for the dog/puppy, I will contact HHR to assist in re-homing and will not re-home the animal through social media or other means. Adoption fees for dogs start at $300. Upon adoption, HHR relinquishes all responsibility of the adopted dog to the new adoptive owner. HHR 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. I agree to alter the animal adopted through Helping Hands Rescue within 2 weeks if animal is not already altered – puppy within 4 months (female)/6 months (male).

I agree to the terms of this agreement.

Available Pets