Adoption Application

Please provide the following information:

Adults in household

1.

2.

Children in home

Address

Telephone

Home Phone

Cell Phone
Notes

Cell Phone 2
Notes

Email

Employment

A successful adoption depends on both the selection of the right basset for your household and the understanding of his/her care taking needs. So that we may assist you with this selection, please answer the following questions:

What type of housing do you have?

Do you rent or own?

If you rent or lease, do you have permission from your landlord to keep a basset indoors?



Do you have a yard?

Is it fenced?



If you don't have a fence, where and how will the dog be exercised and allowed to use the bathroom?

Are you a previous dog owner?

Which breeds have you owned in the PAST?

What types of animal(s) CURRENTLY live in your home? Please list name, breed, age, and how long you've owned each animal. Include dogs, cats, ferrets, rabbits, etc.

Do you currently own animals that live outside, such as other dogs, chickens, feral cats, etc? Please list.

What do you know about basset hounds as a breed?

How do your family members feel about adopting a dog? And why has your family chosen a basset hound?

Is anyone home during the day?

Is anyone home at night?

Are you willing to crate train if needed?

If no, please explain.

Is anyone in the house allergic to pet dander?


Where will the basset be kept while you are away from home or working?

Where will the basset sleep or be kept at night?

Where will the basset be kept when you're away from home on vacation or trips?

Would you consider a "Special Needs" basset such as one that requires daily medication, one who needs obedience training, one who is deaf, etc?

What age basset are you looking for?

Are you familiar with vet costs such as annual shots, routine care and/or unexpected expenditures?

Are you aware of the importance of YEAR ROUND Heartworm preventive and Flea Treatments?

If no, please ask your vet or a CBHR volunteer for more information. Negating these treatments and preventives from your dog's routine can lead to sickness and the possible death of your pet.

Are you willing to have a Home Visit prior to adoption? Visits will be conducted virtually or in person with COVID protocols including masks and social distancing when feasable.

If no, please explain.

Are you willing to allow a CBHR volunteer to conduct a follow up contact after the adoption?

If no, please explain.

Reference Information

If you have owned a pet in the past two years, please provide veterinary name and contact information below.

If you have NOT owned a pet in the past two years, please provide the following reference information: A personal reference, not related to you and not living at the same address. (Provide personal reference ONLY if you have not owned a pet in the last two years.)

Release of Veterinary Information

I authorize any veterinarian or veterinarian hospital/professional/kennel to furnish or discuss with any representative of CBHR all records in their possession regarding the care of their animals past or present. This information will be used in the adoption process of one or more dogs in the care of CBHR. I understand this authorization shall remain valid for one year after the date it is submitted. Upon presentation of this document, a photocopy or facsimile of same, you are directed to permit the personal review with a CBHR representative of any and all vet/kennel records.

I agree to the above terms of release.

Without this agreement, this information cannot be secured and the application cannot be processed. Please also call your veterinarian in advance to authorize release of your information to Carolina Basset Hound Rescue.

Agreement

All of the information I have provided on this application is, to the best of my knowledge, true and complete. I understand falsifying answers on this application, or at any other time during the adoption process, will disqualify the household I represent from adopting a basset from Carolina Basset Hound Rescue (CBHR).

I understand that the processing of this application is contingent upon CBHR being able to find a volunteer who is willing to conduct the in-person home visit. If CBHR is not able to provide a volunteer for the home visit, the application fee will be refunded.

I understand that submitting an application is no guarantee that I will receive a CBHR basset. I further understand that placement of these bassets is at the sole discretion of CBHR and a reason for rejection of an application need not be given. Upon completion and signing of this application and release of any veterinary information, I wish to be considered for ownership of a CBHR basset.

I understand that if I do adopt a basset from CBHR, that should I choose not to keep the basset for any reason that it MUST be returned to CBHR. I also understand that if I do adopt a basset from CBHR, CBHR reserves the right to remove the basset from my home if it is believed that the basset is not being taken care of according to CBHR policies put forth.

I agree to the terms stated above.

Comments

As a final question, we would like to know how you heard about Carolina Basset Hound Rescue.

The $15 adoption application fee can be paid by PayPal or by check or money order. Please indicate your payment method below:

Payment information will appear on the next page, after you click the Submit Application button below.