A successful adoption depends on both the selection of the right basset hound for your household, and the understanding of the hound's care taking needs.  So that we can assist you with this selection, please answer the following questions completely.

Name:

Home Address:

Home Telephone:

Applicant Age: Applicant Email Address:

Occupation:

Employer: Work Telephone:

Would it be possible to call you at work?

About your Family

Total number of adults living in the home?

Total number of children living in the home?

Names and ages of all children living in the home.

Names and ages of all children/grand children that regularly visit.

Are your children/grandchildren knowledgeable about dogs?

Are there any family members who are unsteady on their feet or who have special needs using assistance such as a wheelchair or walker?

If so, please explain.

Is anyone in your home allergic to dogs?

Your Home

In which type of area do you live? (ex: rural, city, suburban area)

In which type of home do you live? (ex: house, apartment, townhouse, mobile home)

Do you own or rent?

How long have you lived at your current address?

If in an apartment or a homeowner's association, do you have written permission to own a large dog over 55lbs?

Prior to adoption, we will need to contact your landlord/property manager.  Please include their name and contact information.

Are there interior stairs in your home? How many?

Are there exterior stairs at your home? How many?

What type of fence do you have? (ex: chain link, privacy, picket, invisible, attached to house, not attached, dog pen, dog run.)  Please explain.

What are your fence dimensions? Height Width Length

Are you willing to reinforce or repair your fence if needed?

If you do not have a fence, what arrangements will you have for the dog's exercise/toilet duties?

Are you willing to have a home visit completed prior to adopting?

Do you have a swimming pool, hot tub, lake, pond or river on or near your property?

Please list all current pets you have in your household.

Type/Breed Altered Sex Age personality Type (*) Vaccines Current? Indoor or Outdoor? Type of heartworm preventative

(*) Personality type (ex: shy, dominant, aggressive, friendly, submissive)

Please tell us why any of your dogs are not spayed or neutered.

Please list all previous pets owned.

Type/Breed Altered Size Indoor or Outdoor?  What happened?

One a scale of 1 to 5, please rate yourself.

Not very dog experienced ...1 ...2 ... 3 ... 4 ... 5 Extremely dog experienced

*Note, not being very experienced foes not automatically disqualify you from adoption.

Your Lifestyle

Does your family anticipate any major lifestyle changes in the next 12 months? (ex: retirement, travel, new baby, moving, new job, job schedule change?) If so, please explain.

What is the activity of your household? (ex: quiet, moderately active, calm, low key, grand central station)

What are the hours that an adult is home during the day?

How many hours a day will your basset hound be left alone?

Are there any rooms in your home that the basset would not be allowed to go into?

Where will your basset be while you are gone?

Where will your basset hound sleep at night?

Most basset hounds that we help are around 2-5 years old.  Would you consider adopting a basset hound that is older?

Who will primarily be responsible for taking care of your new hound?

What type of basset hound do you envision getting? (ex: quiet, calm, moderately active, constant energy)

What role would you like your basset hound to play in your life? (ex: companion, family pet, hunting, breeding, protection)

Are you a first time basset hound owner?

Have you ever taken a dog to a shelter, rescue or human society before?

If so, why?

What made you choose the basset breed?

Do you agree to notify Iowa Basset Hound Rescue if your hound is somehow lost?

I have trained dogs before, and will train this one myself.  Yes No

I have knowledge to take on a hound that might have one or more of the following issues.

Housebreaking Chewing Lacks Manners Needs Socialization Possibly Abused None of these

Please list the issues you are willing to help the dog overcome:

Your Veterinarian

Are you established with a veterinarian?

Please list your vets contact information.

Name:

Address:

City, State, Zip:

Telephone:

How long has your vet been treating your animals?

*Note: We will be contacting your vet if you have any current pets.

How much do you expect to spend on veterinary expenses this year?

Your References

Please list two references that are not family members, and that you have known for at least three years.

Name:

Address:

City, State, Zip:

Telephone:

Name:

Address:

City, State, Zip:

Telephone:

Do you agree to always keep your basset hound on a leash, or in a fenced in yard?

Do you intend for the basset hound to live in the house with you?

Do you agree to keep your basset hound exclusively as a house dog, and agree to never use him/her for fighting, breeding laboratory research, or anything other than a family pet?

Do you agree to notify Iowa Basset Hound Rescue if you cannot keep your basset hound, and to never give up your basset to a pound, shelter, humane society, or any other person or group without permission of Iowa hound rescue?

Do you agree to keep your basset hound on heartworm preventative, and to keep your basset hound current on all vaccinations?

Please tell us your preferences for your adopted basset hound. (Ex: age, color, gender ...)

Are you interested in adopting a certain needy hound that we have in our rescue?

If so, please tell us who.

Will you consider adopting a bonded pair of basset hounds?

Have you ever adopted a basset hound or applied to adopt from us before?

It may take your new hound two weeks or longer to acclimate to your home and family.  Are you prepared to allow this much time to adjust?

Iowa Basset Hound Rescue is licensed in the states of Iowa and Missouri.  Iowa Basset Hound Rescue retain the exclusive right to investigate, approve or reject each applicant.  Stringent criteria must be met by each applicant to insure that each dog is placed in an appropriate home.  The placement of every dog with adoption owners remains with the sold discursion of Iowa Basset Hound Rescue, and specific reasons for approval or rejection are not required.

Iowa Basset Rescue does not refund adoption fees.  When you adopt from our rescue, you are not buying a basset hound.  You are making a donation to our rescue.  We have many dogs waiting for other homes, and your adoption donation is immediately used to bring in another dog who is waiting for a home, spay or neuter, or treat illness in one of our hounds.  If your basset hound does not work in your home, we can try to match you with a different hound that will fit both of your needs.

I certify that the above information is true and correct.

Applicant Signature: Date:

If you have any questions, please contact us:

iabassetrescue@yahoo.com (712.204.9807) Cindy (515.238.3659) Becka (319.653.1509) Anne