Doberman Rescue of Atlanta

Adoption Application

The information you provide in this application will enable us to better determine exactly what you are looking for in a Doberman, which Doberman will fit best into your lifestyle, and how a Doberman would fit into your home. Please be as detailed in your answers as possible to help ensure the best fit between you and your Doberman.

We do not sell the dogs available for adoption. The minimum donation to adopt one of our Dobermans is normally $250.00. This helps cover the cost of the initial rescue, shots, spay/neuter, micro chipping, heartworm testing and other expenses incurred in caring for the dogs.

Applicant Information
Primary Applicant
Name: ______Age: ______
Cell Phone Number:______Home Phone Number: ______
Street Address:______
City/State/Zip:______
Email Address(es): ______
Occupation: ______Employer: ______
Work Days:______Work Hours: ______
Has this person ever been charged with animal cruelty, animal abuse or animal neglect? Yes No
Has this person ever been charged with domestic violence or child abuse or child neglect? Yes No
Secondary Applicant
Name: ______Age: ______
Cell Phone Number:______Home Phone Number: ______
Street Address:______
City/State/Zip:______
Email Address(es): ______
Occupation: ______Employer: ______
Work Days:______Work Hours: ______
Has this person ever been charged with animal cruelty, animal abuse or animal neglect? Yes No
Has this person ever been charged with domestic violence or child abuse or child neglect? Yes No
Family Information
Is everyone in your home agreeable to adopting a Doberman? Yes No
Is anyone in your home allergic to dogs? Yes No
Does anyone in your home have serious health issues? Yes No If yes, explain: ______
______
Does anyone in your home smoke? Yes Yes, but only outdoors No
Do you have children living in the home, full or part time? Yes No If yes, how many? ______
List children’s names and ages: Name: ______Age: ______
Name: ______Age: ______
Name: ______Age: ______
Name: ______Age: ______
Who else lives in the home? ______
Will the dog be exposed to children who do not live in the home? Yes No
If yes how old are the children and under what circumstances will the dog be exposed to them: ______
______
Home Environment
Do you live in a: House Apartment Condo Townhome Mobile Home?
Do you: Rent Own If renting, do we have your permission to contact your landlord? Yes No
Name and phone number of your landlord or leasing company: ______
______
How long have you lived at this address? ______
Do you plan to move any time soon? Yes No If yes, when? ______
Would you ever move somewhere that does not allow a Doberman? ______
Has your home been burglarized or broken into in the past 6 months? Yes No
Are you willing to let a volunteer visit your home? Yes No
Do you have a doggy door? Yes No Do you have a dog run? Yes No
Do you have a fenced yard? Yes No Is the yard fenced on all sides? Yes No
Is the fence attached to the house? Yes No Fence height & material: ______
How will the dog be exercised, whether or not you have a fence? ______
______
Must your new dog get along with regular visitors (human or animal) to your home? Yes No
If yes, please describe:______
______
List any concerns you have about a Doberman and visitors to your home: ______
______
Current Pets
Do you have any dogs? Yes No If yes, how many: ______
List name, gender, age and breed of each dog:
Name: ______Gender: ___Age: ____ Breed: ______
Name: ______Gender: ___Age: ____ Breed: ______
Name: ______Gender: ___Age: ____ Breed: ______
Name: ______Gender: ___Age: ____ Breed: ______
Are all of your dogs spayed/neutered? Yes No
Are all of your dogs up to date on Heartworm preventative? Yes No Which brand? ______
Are all of your dogs up to date on vaccinations? Yes No Not sure
How often do your dogs get vaccinated? Every year Every 3 years Not sure Never
How often do you take your dogs to the veterinarian? ______
What would to do if your dog became unable to control its urine? ______
______
What brand of food do you feed your dogs? ______
How many times a day are they fed?______Do you free feed (leave dog food out)? Yes No
Do you have any cats? Yes No If yes, how many: ______
How do your cats act around dogs? ______
______
Do you have other pets? Yes No If yes, please describe: ______
______
Past Dogs
Please fill out the following information for your past 4 dogs:
Name Age Breed Reason for Passing
______
______
______
______
Were your previous pets spayed/neutered? Yes No If no, please explain: ______
Have you ever given away or sold a pet? Yes No If yes, please explain: ______
______
Veterinarian
Name of current veterinarian:______
Name of current vet clinic: ______
Address: ______City/State: ______
Phone number: ______Name on Account:______
How long have you been going to this veterinarian? ______
Have you taken your pets to any other veterinarians? Yes No If yes, please list: ______
______
______
Do you give us permission to call your veterinarian as a reference? Yes No
What do you expect to spend annually on veterinary care? ______
Daily Routine & Training
Is there someone home during the day? Yes No If yes, whom? ______
Is there someone home at night? Yes No If yes, whom? ______
How long will the dog(s) be home alone each day, on average? ______
Where will the dog be kept when people are home? Indoors Outdoors Both ______
Where will the dog be kept when no one is home? Indoors with free run of house Indoors with access to a dog door
Indoors in a crate or baby gated in a room Outdoors Garage Basement
Explain: ______
Where will the dog sleep at night? ______
Who will take care of the pets when you are out of town? ______
Do you have a Doberman sized crate? Yes No Not sure
Are you planning to crate this dog? Yes No Not sure
What are your feelings about crate use? ______
Who will be responsible for the care and training of this dog? ______
Has this person trained a dog in the past? Yes No
Please describe the training and socialization you plan to provide: ______
______
______
Please check any of the following training methods this person has previously used:
Clicker Training Crate Training Group Obedience Class Private Obedience Lessons Spanking Remote Collar
Sent Dog Away for Training Choke Collar Pinch Collar Shock Collar Martingale Collar
Head Harness (like Gentle Leader)
Have you ever dealt with a major behavior problem? Yes No If yes, please describe problem and how you dealt with it:
______
______
Have you hired a dog trainer in the past? If so, please provide the name and contact info for the trainer:
______
Will your new dog be allowed on the furniture? Yes No Some furniture but not all
Other Considerations
If you were to date or marry someone who did not like your dog, what would you do?______
Do you foresee any major lifestyle changes in the next 15 years (moving, marriage, adding children to your family, divorce, etc.?)
Yes No If yes, please explain: ______
Can you provide a permanent home for this dog for the rest of its life? Yes No
If you are unable to keep this dog for any reason, do you understand you must return the dog to Doberman Rescue of Atlanta?
Yes No I would rather not
Do you agree to contact Doberman Rescue of Atlanta if for any reason you can no longer care for or keep the dog? Yes No
Have you ever adopted a dog from a rescue organization? Yes No
If yes, which rescue: ______
Your Future Doberman
Preferences:
Color: Black Red Blue Fawn Albino Any Any but Albino
Ears: Cropped Natural No Preference Tail: Docked Natural (long) No Preference
Gender: Male Female No Preference
Age: Less than 6 months 6 months – 1 year 1 – 3 years 3 – 7 years Over 7 years No Preference
Is there a specific Doberman you are interested in? ______
Why did you choose this breed? ______
Have you owned a Doberman before? Yes No Have you done any research on the breed? Yes No
Select plans for this dog: Pet Guard Companion for other pet Obedience Agility Search & Rescue
Therapy Service Dog Emotional Support Dog Hiking Jogging/Running
Other Please explain: ______
Personal References
Please list 2 personal references who are not relatives, significant others or roommates:
Name: ______Relationship: ______
Phone number: ______Length of time they’ve known you: ______
Name: ______Relationship: ______
Phone number: ______Length of time they’ve known you: ______
Anything Else?
Is there anything else you would like us to know about you? ______
______
______
______

OTHER TERMS AND CONDITIONS OF THIS APPLICATION

By signing below, I certify that all of the information I have given above is true and complete. I understand Doberman Rescue of Atlanta can reject my application if I provide any false or misleading information in order to obtain a dog.

Doberman Rescue of Atlanta reserves the right to refuse adoption of any Doberman for any reason.

I understand any dog adopted from Doberman Rescue of Atlanta will reside in my home as a pet.

I understand Doberman Rescue of Atlanta will inspect my home as part of their investigation into the suitability of the dog’s living quarters.

I must agree to provide my Doberman with adequate food, water, shelter, training, affection and medical care, as more fully set out in the Doberman Rescue of Atlanta Adoption contract.

• Many dogs in Rescue are obtained from shelters or other situations where information about their past, their medical background and their behavioral background is incomplete or not available.

I understand that Doberman Rescue of Atlanta and/or its authorized agents, officers, Board of Directors and members are not responsible for the accuracy of information received about the temperament, habits and physical condition of dogs available for adoption.

Doberman Rescue of Atlanta, its officers, Board of Directors and members, and any person associated with its adoption efforts, are in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household, as more fully set out in the Adoption contract I will be required to sign as a condition of my adoption of any dog from Doberman Rescue of Atlanta.

I also understand that I will be required to sign an adoption contract to place a dog in my home. I am in full agreement with these terms of adoption. By signing below I acknowledge that I have read and understand the Terms and Conditions of this Application.

Applicant’s signature: ______Date: ______

Applicant’s signature: ______Date: ______

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