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DONATE & OTHER WAYS TO HELP

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ONLINE DONATIONS

ONLINE DONATIONS

PORTLAND DACHSHUND RESCUE INC ADOPTION FORM

Name of dog applying for:

About you

Name

Phone (No parenthesis or dashes)

Email

Address (including City/State)

I live in a:

Home

Apartment

Townhome/Condo

I currently:

Rent

Own

If you rent, do you have your landlord's permission to have a pet?

Yes

No

Not Applicable (Own)

I smoke:

No

Yes

Yes but not inside

Yes but not cigarettes or cigars

Do you have a securely fenced yard?

Yard Photo 1

(Max file size is 15MB)

Yard Photo 2 (Optional)

(Max file size is15MB)

List all dog(s) including breed & age

Current pets residing in your home

List all cat(s), including age

Please list any other pets (and specify type of animal)

Do all of you pets get along with both male and female dogs? Please specify if you can only adopt one gender:

Family Unit

Who lives in your home (check all that apply)?

Adults

Teens 15-19

Kids 10-14

Kids 5-9

Kids 1-4

How many people total live in your home?

Is everyone in the household in agreement about adopting?

Schedule

I work:

From home

Part-time

Full-time

Stay at home

Retired

Does your family have staggered work schedules?

Maximum hours the adoptive pet would be alone per day?

Adoptive Preferences

I am willing to adopt a dachshund that (check all that apply):

Has separation anxiety

Takes medication

Is partially potty trained

Is NOT potty trained

Is recovering from surgery

Has a bite history

Is a senior

Isn't reliable around kids

Where will the dog sleep?

In a crate or bed

In or on my bed

Wherever it is most comfortable

Are you aware that dachshunds are predisposed to back problems and may need ramps and stairs around the house?

Would you be willing to purchase stairs and a ramp?

Yes

No

Already own them

Vet Reference

I am willing to get a reference from my vet vouching for the consistent care of my current/past pets

Yes

No

Not applicable- 1st time pet owner

Current/Past Vet Name

Phone Number (No dashes or parenthesis):

Have you ever surrendered or given up a pet before? If so, please explain the circumstances:

What methods would you use to train your dog (if it needed additional behavioral or potty training)?

Please explain the reason you would like to adopt a rescue dog:

You will receive an email confirmation if we successfully received your online application.

Spokesdog Hank Doodle

Spokesdog Hank

Details

2017 NW Vaughn St. Box 96294

Portland, OR 97209

(971)227-6485

april@portlanddachshundrescue.org

anne@portlanddachshundrescue.org

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© 2020 by Portland Dachshund Rescue, Inc.

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