This may seem like an excessively detailed,
even invasive, questionnaire, but please keep in mind that the more information
we have about you, your household and your expectations of your rescued dog, the
easier it will be to make a successful match.
Finding the perfect match between adopter and dog is our most important
Are you inquiring about a specific dog? ______ If Yes, Name of
Cell Phone: ____________________________
Email Address: _____________________________
Please list their names, ages and occupations:
Please list their names and ages: ___________________________________________________
Who will be the primary caregiver for
the new dog? ________________________________
If so what are you plans for letting the dog
out to potty during the day? ________________
If you are out of WA state, have you checked with your state's Basset
If not, why ____________________________________________________________
If you are out of the adoption
area, what are your plans for transporting this basset?
Do you own or rent? __________
of the property owner: ___________________________________________________________
Do you have a securely fenced yard?
If so, what type of fence is it (wood, chain
link, block wall, etc.)? ______________________
How high is it? ______________________________
Under what circumstances would you allow your
dog to be off-leash? __________________
Are there any areas of the house where
the dog will not be allowed? _________________
If so, how will you keep the dog out of them?
If not, how will you keep it off the
Will the dog be given the run of the house
when no one is at home? ___________________
Where will the dog sleep? _______________________________________________________
Have you ever trained a dog to respond to
simple commands? _______________________
If so, how would you describe the method you
How will you discipline your new dog for
undesirable behavior? _______________________
If your new dog is not housetrained, how will
you housetrain it? _________________________
Are you aware that even housetrained dogs need
a period of adjustment in a new home? ___
What will you do if the dog has “accidents”
in the house?_______________________________
How many dogs have you owned? ___________________________________________________
How long did you have your last dog?
_________________ How long ago? ________________
Did you have the dog until it died?
____________ If so, at what
age did it die? ____________
If not, what happened to it?
Was it spayed/neutered? __________________________________________________________
Do you currently have a dog (s)? __________
If so, please list their breed, age, sex and whether they are
what arrangements will you make for the care of your rescued dog? ______________________
Why do you want a dog (or another dog)
at this time?___________________________________ _________________________________________________________________________________
If not, what are you interested in a basset?
What characteristics do you especially
want in your new dog? ______________________________
provide the name and phone number of your current or previous veterinarian:
provide the names and phone numbers of two personal references,
not including family members: ________________________________________________________________________________
you agree to have a representative of Washington Basset Rescue visit your home
prior to adoption? __________________________________________________
you agree to pay an adoption fee, depending on the dog’s age, health and
possible special needs? ____________________________________________________
If you move, what are your plans for the dog? ____________________________________________________________________________________
I agree to provide adequate food, shelter, water, medical treatment and
humane treatment at all times.
I understand that Washington Basset 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 will not be refunded after a period of 2 weeks.
WABR will not be held liable for any personal liabilities or damage to
property or financial indebtedness incurred for the care of the adopted animal
you for completing this application and thank you for wanting to give a forever
home to one of our rescued animals!
Benstine, 7220 N. Haven,